0:00:00.300,0:00:04.989 For a long time, it was believed that the human brain was fixed or hardwired 0:00:05.300,0:00:09.130 and most forms of brain damage were therefore permanent and irreversible. 0:00:09.409,0:00:13.380 However, scientists have since come to realize that far from being fixed, 0:00:13.510,0:00:18.479 the brain has remarkable powers to regenerate itself even in old age. 0:00:18.829,0:00:21.649 Norman Doidge is a psychiatrist and medical researcher. 0:00:22.000,0:00:27.270 In his new book, he explores the impact of this revolutionary discovery on all of us. 0:00:27.280,0:00:30.149 It's called "The Brain That Changes Itself." 0:00:30.159,0:00:33.979 Stories of personal triumph from the frontiers of brain science. 0:00:34.990,0:00:38.319 For years, we've been told that the human brain is like a machine, 0:00:38.330,0:00:40.220 a computer that there are different parts 0:00:40.229,0:00:42.180 that they're responsible for different functions. 0:00:42.189,0:00:47.759 And if those parts break or wear down or damaged, we lose that function. 0:00:47.900,0:00:51.299 Now, in your new book, you throw this all on its head and you say that in fact, 0:00:51.310,0:00:53.029 the brain is plastic, 0:00:53.169,0:00:54.979 explain what that means. 0:00:54.990,0:00:58.500 Well, plastic means plastic in the sense of Plasticine, 0:00:58.509,0:01:00.889 modifiable, adaptable. 0:01:01.270,0:01:02.909 The plastic brain is a brain that can 0:01:02.919,0:01:05.410 change its structure and its function depending on 0:01:05.620,0:01:06.250 both... 0:01:06.660,0:01:08.419 Without drugs or invasive... 0:01:09.000,0:01:11.300 Without drugs. Just depending on what you do with your brain. 0:01:11.800,0:01:14.790 The task at hand that you are working on, 0:01:15.089,0:01:18.709 what you're perceiving can cause you to change the structure of your brain 0:01:18.879,0:01:21.750 on many levels 0:01:21.980,0:01:23.699 and this is the most fantastic part, 0:01:23.709,0:01:27.290 what you think and imagine actually can change the structure of your brain 0:01:28.209,0:01:28.639 down 0:01:28.879,0:01:32.610 to the very connections between the brain cells, down into the genes 0:01:32.620,0:01:33.589 even for instance. 0:01:34.809,0:01:36.150 One of the most, 0:01:36.830,0:01:37.330 you know, 0:01:37.339,0:01:39.970 staggeringly interesting discoveries of the late 0:01:39.980,0:01:42.569 20th century was the discovery that learning 0:01:42.959,0:01:46.400 changes the number of connections between the neurons, 0:01:46.730,0:01:49.830 the nerve cells in a nervous system. 0:01:50.120,0:01:53.449 You can go, for instance, from having perhaps 1300 0:01:53.589,0:01:55.069 connections between 0:01:55.199,0:01:58.010 nerve cell A and nerve cell B to 2700 0:01:58.279,0:02:02.839 with several hours of training. By virtue of more brain activity occurring, 0:02:03.110,0:02:05.540 By virtue of learning and brain activity. So, 0:02:05.800,0:02:09.130 what happens is thoughts 0:02:09.309,0:02:11.369 or activities that you do with your brain 0:02:11.529,0:02:15.440 actually turn certain genes on and others off inside the nerve 0:02:15.449,0:02:18.820 cells, which then make proteins which then change the structure. 0:02:18.830,0:02:19.080 Now, 0:02:19.089,0:02:22.759 why is this discovery considered so revolutionary and more particularly what 0:02:22.770,0:02:26.979 are the implications of this discovery for people with brain dysfunction? 0:02:27.419,0:02:31.360 A stroke for example. When you had a stroke, the general assumption was 0:02:32.199,0:02:37.820 your brain got swollen, the chemicals were kind of deranged and after a few weeks, 0:02:38.300,0:02:40.440 whatever you were left with was what you would have 0:02:40.449,0:02:41.740 to live with for the rest of your life. 0:02:41.750,0:02:43.339 You basically lost that brain 0:02:43.479,0:02:47.339 function that was damaged. The cells died, they couldn't be replaced, 0:02:47.479,0:02:49.919 the healthy ones around it couldn't reorganize. 0:02:50.360,0:02:51.779 And so, 0:02:52.509,0:02:54.210 we were kind of waiting for the swelling to 0:02:54.220,0:02:56.460 go away and rehab was just sort of focused on 0:02:56.639,0:02:59.850 getting you over that period. Now, we know that rehab can actually 0:03:00.190,0:03:05.250 reorganize the brain if it's done properly and bring many new functions back. 0:03:05.330,0:03:07.429 But if I could just say it, it also meant 0:03:07.720,0:03:08.210 that 0:03:08.490,0:03:13.169 as you started to get older and your brain started to decline. 0:03:13.630,0:03:15.529 It was like a machine that was wearing out 0:03:15.770,0:03:19.050 and the attempt to exercise your brain in the second half 0:03:19.059,0:03:22.369 of life was really kind of unwarranted or waste of time. 0:03:23.029,0:03:24.289 And so, we just 0:03:24.509,0:03:28.479 accepted a view of human development in which 0:03:28.679,0:03:33.110 the second half of life is a period of necessary mental decline. 0:03:33.309,0:03:36.580 And then, of course, the whole view of human nature that we have, you know, 0:03:36.589,0:03:39.210 since the rise of modern science, most 0:03:39.429,0:03:44.169 educated people see human nature in some way is emerging from the human brain. 0:03:44.179,0:03:46.419 And if the human brain was fixed, immutable 0:03:46.600,0:03:48.100 and a rigid structure, 0:03:48.429,0:03:51.850 it made a lot of sense to think of human nature as fundamentally fixed. 0:03:52.160,0:03:52.710 And so, 0:03:53.149,0:03:57.339 we have to re-examine all that and I begin to do that in this book. 0:03:57.350,0:04:00.369 Well, you do it by way of story and that there's some remarkable, 0:04:00.529,0:04:03.289 almost logic defying, remarkable, 0:04:03.300,0:04:05.639 given what our traditional notion of what the brain is, 0:04:05.649,0:04:07.649 probably the most remarkable. 0:04:07.660,0:04:12.490 And it is the story of a woman who was born with half a brain. Tell me about Michelle. 0:04:12.740,0:04:15.369 I went to visit Michelle because I thought that 0:04:16.100,0:04:20.480 I knew that she was born with one hemisphere alone, 0:04:20.488,0:04:21.350 just half a brain. 0:04:21.358,0:04:21.608 And, 0:04:21.880,0:04:24.119 I thought that whatever changes that she was able 0:04:24.130,0:04:26.549 to undergo would really test this notion of 0:04:26.649,0:04:29.399 plasticity, certainly, at least in early life. 0:04:29.779,0:04:30.869 And 0:04:31.450,0:04:36.269 basically, when she was in the womb, some catastrophic event occurred, so 0:04:36.489,0:04:38.609 her left hemisphere never developed. 0:04:39.350,0:04:39.850 And 0:04:40.160,0:04:43.390 based on what, you know, the usual view of 0:04:43.549,0:04:44.010 that 0:04:44.019,0:04:47.000 the brain basically has certain areas which in the left 0:04:47.010,0:04:49.959 hemisphere which are responsible for speech and other functions, 0:04:50.720,0:04:53.529 someone with that level of damage you would imagine 0:04:54.640,0:04:59.779 would be unable to speak, unable to think, they might be alive, but on a respirator. 0:05:01.399,0:05:04.179 And it turns out that that's not the case with Michelle. 0:05:04.989,0:05:06.290 In fact, 0:05:06.670,0:05:07.959 if you met Michelle, 0:05:07.970,0:05:13.399 you would detect some subtle things like one of her arms is a little twisted, 0:05:13.410,0:05:14.059 et cetera 0:05:14.299,0:05:14.820 and 0:05:15.470,0:05:18.970 her speech when she's upset, it's a little repetitive, 0:05:19.200,0:05:20.670 but you would never dream. 0:05:20.679,0:05:24.850 And nor did the people who examined her for a number of years dream 0:05:25.109,0:05:26.989 that she had half a brain. Well, explain to this 0:05:27.000,0:05:29.690 now, if we had thought that 0:05:29.700,0:05:31.619 this part of the brain is responsible for speech 0:05:31.630,0:05:33.130 and I don't have this part of the brain, 0:05:33.290,0:05:34.570 How is Michelle speaking? 0:05:34.730,0:05:37.369 We know that there's a lot of plasticity early in life. 0:05:37.380,0:05:40.519 But we also know and I make this very clear in the book, 0:05:40.529,0:05:42.489 there's plasticity from cradle to grave. 0:05:42.850,0:05:46.269 But you know, there are waves of increased plasticity 0:05:46.570,0:05:49.429 and it turns out that what the brain does is 0:05:49.769,0:05:53.429 it learns how to do what it's got to do at the time. So, 0:05:53.929,0:05:55.589 parts of the brain that might have been 0:05:55.600,0:05:57.519 devoted to other things will learn how to move. 0:05:57.529,0:06:00.779 If it has to see to survive, they'll be devoted to vision. 0:06:01.049,0:06:01.700 And so 0:06:01.899,0:06:02.299 all 0:06:03.149,0:06:06.119 these things can actually be organized and move around, 0:06:06.850,0:06:10.660 these higher mental functions. To give our viewers even more 0:06:10.670,0:06:12.420 kind of appreciation of the extent to which 0:06:12.429,0:06:13.549 that's possible. 0:06:13.730,0:06:17.399 Retell the story that's in the book that 0:06:17.410,0:06:19.640 you dub the woman who is perpetually falling. 0:06:20.769,0:06:21.869 Cheryl Schiltz 0:06:22.429,0:06:23.390 was a woman. 0:06:23.399,0:06:25.160 She had a hysterectomy and she was given 0:06:25.170,0:06:28.019 a medication because she developed an infection called gentamicin 0:06:29.119,0:06:29.730 and 0:06:30.200,0:06:34.619 it poisoned the vestibular apparatus, which is the balance apparatus in her brain. 0:06:34.929,0:06:36.480 And if you lose your sense of balance, 0:06:36.709,0:06:40.000 you will feel like you're perpetually falling. When I was with Cheryl at one point, 0:06:40.160,0:06:43.459 I asked her, "What's it like when you've finally fallen to the floor? 0:06:43.769,0:06:45.339 What do you feel at that point?" 0:06:45.640,0:06:46.299 And then she says, 0:06:46.309,0:06:50.160 "Sometimes, I just feel the floor opens up and I fall into a perpetual abyss." 0:06:50.170,0:06:52.899 So that was her life and she ended up on disability. 0:06:53.660,0:06:54.880 And one of the great 0:06:55.250,0:06:55.799 people 0:06:55.929,0:06:58.160 who were at the cutting edge, 0:06:58.170,0:07:01.079 I call these people "neuroplastician" to coin a phrase, 0:07:01.250,0:07:01.769 Paul 0:07:02.160,0:07:02.480 Bach-y-Rita 0:07:03.410,0:07:05.230 invented a mechanism 0:07:05.450,0:07:07.980 and I was there when she was using the mechanism for one 0:07:07.989,0:07:11.829 of the first times that basically was attached to an accelerometer. 0:07:11.839,0:07:13.630 An accelerometer is like a gyroscope. 0:07:14.119,0:07:14.549 And 0:07:15.290,0:07:16.470 she would... 0:07:16.619,0:07:20.269 The accelerometer would be in a hat on her head. Like a construction hat. 0:07:20.279,0:07:21.700 Like a construction hat. 0:07:21.950,0:07:26.470 And it would give signals that went into her tongue of all places 0:07:27.350,0:07:29.709 telling her where she was in space. I tried it on. 0:07:29.720,0:07:32.709 So when you lean forward and you feel like champagne bubbles, 0:07:32.720,0:07:35.940 they're really little electric shocks, tell you you're forward, you lean back, 0:07:35.950,0:07:36.739 it goes back 0:07:37.279,0:07:38.890 and she would put this hat on. 0:07:39.540,0:07:40.040 And 0:07:40.750,0:07:41.609 immediately 0:07:42.309,0:07:47.209 she would... Normally, she'd be holding herself like up on a table lest she fall 0:07:47.670,0:07:49.850 and immediately her whole body relaxed. 0:07:50.880,0:07:53.470 And this seemed like a miracle. Why? Because 0:07:54.220,0:07:55.179 the sensory 0:07:55.380,0:07:57.299 apparatus, the 0:07:57.309,0:07:59.480 sense of touch on the tongue goes to a 0:07:59.489,0:08:01.760 different part of the brain and the balance apparatus. 0:08:01.769,0:08:01.790 So 0:08:02.070,0:08:04.980 somehow or rather these signals coming in 0:08:05.619,0:08:11.079 were making new pathways or strengthening very dormant pathways between 0:08:11.470,0:08:14.239 her sense of touch and her sense of balance, 0:08:14.510,0:08:18.079 so that was the first miracle I saw that happening and she had tried it on. 0:08:18.500,0:08:18.839 But 0:08:19.950,0:08:22.440 then there was a second miracle which 0:08:22.450,0:08:25.010 is as she started to use the machine more, 0:08:26.040,0:08:28.059 she found she had a residual period 0:08:28.640,0:08:29.179 where 0:08:29.970,0:08:31.350 she would take the hat off. 0:08:32.409,0:08:34.849 And at first, the residual period lasted 0:08:34.979,0:08:37.429 30 seconds. Residual period being that she still had balance. (MULTIPLE VOICES). 0:08:38.090,0:08:38.409 Exactly. 0:08:39.070,0:08:39.210 That's 0:08:39.429,0:08:39.489 right. 0:08:40.159,0:08:42.750 It lasted for, you know, a few seconds and then 0:08:42.890,0:08:44.309 it lasted longer and longer. 0:08:44.320,0:08:47.390 And as she started to use the hat and take it home and use it, 0:08:47.940,0:08:50.229 she would be going for days. And 0:08:50.840,0:08:53.909 that was a true miracle because what was happening was 0:08:54.059,0:08:54.869 a miracle. I mean, 0:08:55.010,0:08:55.890 it's only a miracle 0:08:55.900,0:08:59.750 if you think that the brain is fixed, it's actually not a miracle. 0:09:00.080,0:09:00.489 because 0:09:00.909,0:09:03.239 she now no longer considers herself a 0:09:03.250,0:09:05.619 wobbler. Because the brain reordered itself and put 0:09:05.750,0:09:07.669 the balance in a different part of the brain that wasn't then. 0:09:07.869,0:09:11.510 Yeah. And, it developed new paths. Now, is this sensory substitution? 0:09:11.520,0:09:12.020 I mean, this is again, 0:09:12.030,0:09:16.250 another fascinating notion he introduces. This is what 0:09:16.729,0:09:17.219 Paul 0:09:17.419,0:09:19.450 Bach-y-Rita called sensory substitution. He did 0:09:20.099,0:09:20.530 this 0:09:20.929,0:09:24.940 as well for people who had been congenitally blind, 0:09:24.950,0:09:26.049 they've never seen anything. 0:09:26.590,0:09:26.989 And, 0:09:27.000,0:09:31.729 he rigged up a camera to a computer and then attached it originally just to the back 0:09:32.099,0:09:34.330 and there were vibrating pixels that were on the back. 0:09:34.340,0:09:36.250 And then he put it in to the tongue 0:09:36.630,0:09:39.849 and he found that he could train a human tongue 0:09:40.679,0:09:42.780 to function like a retina. 0:09:42.950,0:09:44.940 And they would be able to see Twiggy. 0:09:45.340,0:09:47.400 They would say, "Well, that's a picture of Twiggy." 0:09:47.409,0:09:52.039 That's a picture of a vase...you've just moved a vase in front of a telephone, 0:09:52.049,0:09:53.659 they could read certain things. 0:09:54.270,0:09:58.200 If you threw a ball at them, they would duck, they could see perspective. 0:09:58.210,0:09:59.650 I mean, so this is remarkable. 0:10:00.099,0:10:00.330 They could see through the tongue. 0:10:00.940,0:10:04.010 What was happening is the tongue is like a two-dimensional surface 0:10:04.179,0:10:06.049 just as the retina, 0:10:06.190,0:10:07.270 the retina is. 0:10:07.690,0:10:08.340 And yeah, 0:10:08.539,0:10:09.909 basically... 0:10:10.250,0:10:10.859 The images would be... 0:10:11.030,0:10:12.200 Images would be on the tongue. 0:10:12.210,0:10:16.130 And then, we've recently learned, actually, this was some work also done 0:10:16.140,0:10:16.900 in Canada, 0:10:17.049,0:10:18.609 Bach-y-Rita was from the states 0:10:19.030,0:10:19.450 that 0:10:20.229,0:10:24.690 the input coming into the tongue was processed in the back of the brain, 0:10:24.739,0:10:27.510 which we tend to call the visual cortex. 0:10:27.520,0:10:29.500 So it was all being rerouted 0:10:29.840,0:10:30.289 and 0:10:30.770,0:10:31.349 Paul 0:10:31.460,0:10:34.460 Bach-y-Rita has found different ways to do sensory substitution, which is 0:10:34.719,0:10:38.710 lay the groundwork for the notion of a retinal implant, but, 0:10:38.880,0:10:41.229 you know, helping other people who have 0:10:41.239,0:10:43.109 literally lost the ability to sense certain things. 0:10:43.119,0:10:46.669 We touched on the whole issue of stroke victims. 0:10:46.679,0:10:49.880 And that you can tell a great story here about a surgeon in 0:10:50.289,0:10:54.099 his mid 50s had a terrible debilitating stroke. 0:10:54.530,0:10:56.950 Tell me how he came back. Michael Bernstein, 0:10:56.960,0:11:00.309 yeah, out, he was playing tennis. He was a tennis... 0:11:00.320,0:11:03.219 He spent the morning doing surgery on the eyes, 0:11:03.229,0:11:07.580 so he needs a lot of fine motor skills. It's microscopic surgery. 0:11:07.590,0:11:09.989 It's in a small confined space. 0:11:10.330,0:11:11.309 Then, he was playing tennis, 0:11:11.320,0:11:14.049 then he developed a stroke and he couldn't move one side of his body. 0:11:14.400,0:11:16.510 He went for conventional rehabilitation, 0:11:16.590,0:11:18.820 they gave him whatever it was the 4 to 6 weeks. 0:11:20.929,0:11:24.419 And basically, they said you're on your own and he had very, 0:11:24.429,0:11:28.580 very little control of his arm at that point and very little control of his leg, 0:11:28.590,0:11:29.700 and then he tried a new 0:11:30.109,0:11:31.270 form of treatment. He 0:11:31.630,0:11:33.030 happened to be from Birmingham, 0:11:33.039,0:11:36.770 Alabama where a man named Edward Taub had 0:11:36.780,0:11:39.619 developed this new treatment called constraint-induced therapy. 0:11:40.309,0:11:40.799 And 0:11:41.489,0:11:45.299 one of the things that neuroplasticians have shown in hundreds of experiments 0:11:45.309,0:11:47.349 now is that it's use it or lose it brain. 0:11:48.130,0:11:50.909 If you don't use something, 0:11:51.150,0:11:54.989 it's that cortical real estate is taken over by something else. 0:11:55.469,0:11:55.989 Now, 0:11:56.359,0:11:58.830 what happens when a very common form 0:11:58.840,0:12:00.719 of stroke is you have a stroke in the left 0:12:01.070,0:12:03.150 hemisphere and you can't move your 0:12:03.349,0:12:04.630 right hand. You're paralyzed. 0:12:05.409,0:12:07.109 You can't move it well, et cetera. 0:12:07.390,0:12:09.590 And so people try to use their arms, 0:12:09.989,0:12:10.909 it doesn't work 0:12:11.580,0:12:12.119 and 0:12:12.400,0:12:13.719 so they stopped using them. 0:12:13.880,0:12:14.359 Now, 0:12:14.520,0:12:16.789 what Taub did ingeniously was, 0:12:17.190,0:12:19.609 he got people to put their good hands in slings. 0:12:19.780,0:12:21.760 Constrain them. He constrained them 0:12:22.010,0:12:24.280 and then if a person could just do this, 0:12:24.679,0:12:26.539 he would give them small amounts just to get 0:12:26.549,0:12:28.840 a little more control over that very incremental, 0:12:29.099,0:12:31.000 and he worked them very, very hard. 0:12:31.210,0:12:34.559 And they would have to do things like, you know, try to wash pots. And, 0:12:34.950,0:12:37.729 you know, people would come in, they couldn't dress themselves, they 0:12:37.739,0:12:39.989 couldn't eat, they couldn't put food on a fork. 0:12:40.000,0:12:42.549 They literally would have been dependent for the rest of their lives. 0:12:42.900,0:12:45.030 And Michael Bernstein was one of the first to go 0:12:45.039,0:12:47.770 through this and after two weeks of very intensive training, 0:12:47.780,0:12:49.390 and that's not a long time. No. No. 0:12:49.630,0:12:49.659 It 0:12:49.809,0:12:49.969 isn't, 0:12:50.270,0:12:54.650 He was able to function, get back to work and function as a surgeon. 0:12:55.479,0:12:59.270 And there are people who went to Taub clinic, there was one person 0:12:59.280,0:13:00.130 I spoke to had 0:13:00.140,0:13:03.179 a stroke almost 50 years before. He had been 0:13:03.190,0:13:05.270 a little boy playing baseball when he had a stroke. 0:13:05.390,0:13:06.409 They 0:13:06.739,0:13:08.650 could help him. All these years, 0:13:08.659,0:13:09.789 after the fact, I mean, 0:13:09.840,0:13:12.489 that's just so remarkable because that plasticity 0:13:12.500,0:13:14.090 and the ability to reorganize 0:13:14.099,0:13:15.030 is in the brain. 0:13:15.289,0:13:18.250 And it has even helped people who've had traumatic injuries, 0:13:18.260,0:13:19.669 traumatic brain injuries. 0:13:20.150,0:13:22.489 I think that's the kind of thing that would be very helpful 0:13:22.830,0:13:23.450 for 0:13:23.669,0:13:27.130 anyone who's got those kinds... Well, not anyone but many people with 0:13:27.789,0:13:30.000 traumatic brain injuries, for instance, 0:13:30.010,0:13:32.289 think of the soldiers getting back from Afghanistan. 0:13:32.419,0:13:37.070 Is this kind of therapy or are these kinds of treatments now finding their way 0:13:37.080,0:13:38.070 into medical practice? 0:13:38.080,0:13:38.130 Not quite. 0:13:38.609,0:13:41.609 No, because normally when someone has a stroke or any kind of brain damage, 0:13:41.760,0:13:43.239 I mean, we really do look on it very, 0:13:43.250,0:13:46.530 very fatalistically and if the evidence is what we should, they don't improve. 0:13:47.049,0:13:47.669 Yeah look. 0:13:47.679,0:13:50.929 We look on it fatalistically in part because studies that have been 0:13:50.940,0:13:54.469 done in the past and people with brain damage and strokes showed that 0:13:54.690,0:13:55.960 interventions didn't work. 0:13:55.969,0:13:59.590 But now that the neuroplasticians have laid out the laws of this new science, 0:14:00.039,0:14:03.609 there's reason to be hopeful for a number of kinds 0:14:03.619,0:14:04.640 of brain injuries. 0:14:04.650,0:14:05.109 I bet, 0:14:05.119,0:14:07.729 the notion of phantom pain again 0:14:07.739,0:14:10.900 documented that people who lose limbs that they continue to 0:14:11.169,0:14:11.909 to hurt. 0:14:12.169,0:14:13.729 You again claim that 0:14:13.739,0:14:17.590 neuroplasticity both explains this and that researchers 0:14:17.599,0:14:21.270 using the theories of neuroplasticity have been able to cure phantom pain. 0:14:21.280,0:14:22.049 Tell me about that. 0:14:22.450,0:14:26.859 Well, phantom pain was one of the great mysteries of medicine. 0:14:26.869,0:14:29.710 How is it possible to feel pain in a limb that isn't there? 0:14:29.880,0:14:31.950 And what a neurologist named 0:14:32.320,0:14:34.229 Ramachandran discovered was 0:14:34.750,0:14:37.390 that in patients who've lost their arms and then 0:14:37.400,0:14:40.429 get pain or in one case in scratch or itches, 0:14:40.440,0:14:41.539 What happens is 0:14:41.780,0:14:43.010 if you remove an arm, 0:14:43.969,0:14:47.150 there's cortical real estate if you will, that had been devoted to 0:14:47.260,0:14:50.469 moving that arm and feeling for that arm, it's now dormant. 0:14:50.869,0:14:51.340 In the brain. 0:14:51.559,0:14:51.979 In the brain. 0:14:53.119,0:14:56.950 So adjacent cortical real estate takes it over. 0:14:57.409,0:14:58.030 And 0:14:58.369,0:15:01.349 in the typical human body map, 0:15:01.599,0:15:04.929 an area that's very close to the arm is actually the face. And 0:15:05.099,0:15:10.989 we now know that phantom pain is often caused because the face maps in the brain 0:15:11.969,0:15:15.669 say, "Hey, there's more cortical real estate for us and they start to move in there 0:15:16.390,0:15:16.969 and 0:15:17.179,0:15:17.609 reorganize 0:15:17.849,0:15:21.729 the brain." There was one patient he had who had an unscratchable itch, 0:15:21.739,0:15:23.960 so that was a terrible affliction for him. 0:15:24.229,0:15:24.570 And 0:15:25.130,0:15:28.090 Ramachandran eventually figured that if you just scratched the man's cheek, 0:15:28.559,0:15:29.969 the itch went away. And 0:15:30.530,0:15:33.710 Ramachandran was able by the way to sort of trick the brain 0:15:34.260,0:15:39.210 into rewiring itself using this same neuroplasticity. 0:15:39.479,0:15:41.419 One of the reasons that people would 0:15:41.650,0:15:46.169 have these frozen pains is because once the input is stopped into the brain 0:15:46.820,0:15:47.250 from, 0:15:48.109,0:15:49.289 you know, from the arm, 0:15:49.739,0:15:50.849 it's as though 0:15:51.010,0:15:53.890 that's the picture that remains in the brain, there's no 0:15:54.250,0:15:57.369 new input to say. Now the arm is moving again. 0:15:57.500,0:15:59.080 Many people who had phantoms 0:15:59.200,0:16:01.169 felt their arms were frozen and in pain. 0:16:02.309,0:16:05.869 So, he set up a mirror device where you would look at what your real arm, 0:16:06.210,0:16:07.729 let's say this arm had been cut off. 0:16:07.979,0:16:10.820 You'd look at your real arm and then you look into a mirror right here. 0:16:10.830,0:16:12.409 The brain would be tricking you thinking that your arm was... 0:16:12.659,0:16:15.770 Think that your left arm was moving, that which, of course, didn't exist, 0:16:15.780,0:16:17.489 you'd kind of put your stump near it 0:16:17.969,0:16:18.489 and 0:16:18.869,0:16:22.369 that rewired the map so that the frozen phantom could move. 0:16:22.619,0:16:22.789 Now, 0:16:22.799,0:16:25.150 I understand that neuroplasticity also tells us something 0:16:25.159,0:16:27.969 about the nature of sexual attraction and love. 0:16:28.369,0:16:28.890 What is that? 0:16:29.390,0:16:33.239 There's tremendous variation, of course, in what people are turned on by, 0:16:33.250,0:16:34.500 let's say sexually, I mean, 0:16:34.919,0:16:36.359 you know, take 0:16:36.559,0:16:38.969 situations in other cultures 0:16:39.409,0:16:41.900 seem unnatural sometimes. 0:16:41.909,0:16:45.690 And we learned that people can develop attractions. If you think of 0:16:45.919,0:16:49.929 the whole idea that Chinese men 100 years ago in the aristocracy were 0:16:49.940,0:16:53.369 totally turned on by women who had their feet broken and bound up. 0:16:53.940,0:16:54.409 Okay. 0:16:55.200,0:16:59.219 We start to realize that sexual tastes can be acquired and we 0:16:59.229,0:17:01.059 we can acquire sexual types. 0:17:02.059,0:17:04.719 And we're seeing a lot of this happening now actually 0:17:04.729,0:17:06.819 with the internet and internet porn in a way. 0:17:07.130,0:17:09.719 You know, there are a lot of stories that started to 0:17:10.540,0:17:10.989 become 0:17:11.920,0:17:14.329 public in the nineties about men 0:17:14.469,0:17:15.858 who would get on the internet 0:17:16.670,0:17:19.040 and they'd sort of just be searching 0:17:19.050,0:17:21.650 around and then they fasten on to certain images 0:17:21.930,0:17:24.348 that would really turn them on, that really surprise them. 0:17:24.358,0:17:27.329 And then they would practice them over and over and over again 0:17:27.729,0:17:32.349 and they would have orgasms and when a person has an orgasm, they secrete a 0:17:32.369,0:17:36.170 brain chemical called dopamine, which actually reinforces the circuit 0:17:36.280,0:17:37.170 and rewards them. 0:17:37.599,0:17:42.219 So, dopamine is a neurotransmitter or a brain chemical 0:17:42.359,0:17:45.319 that's very involved in consolidating a new circuit. 0:17:45.329,0:17:48.719 And these men would start to develop new sexual attractions 0:17:49.000,0:17:51.219 that at times seemed bizarre to them, 0:17:51.630,0:17:53.739 sometimes they dipped into childhood things. 0:17:53.750,0:17:54.010 I mean, 0:17:54.020,0:17:55.849 one story I talked about in the book is 0:17:55.859,0:17:58.300 a man who developed an attraction to spanking sites. 0:17:58.310,0:18:01.500 And if you think about it, spanking would seem to have to do with early childhood. 0:18:01.969,0:18:04.359 But the other thing that was happening for these men and this 0:18:04.369,0:18:06.949 was reported over and over and I saw it in clinical practice 0:18:07.199,0:18:07.750 is 0:18:07.979,0:18:11.189 they said that for a mysterious reason, they were losing 0:18:11.500,0:18:12.910 interest in 0:18:13.219,0:18:13.949 their own 0:18:14.290,0:18:17.670 partners, even though objectively they found them to be attractive. 0:18:18.000,0:18:19.910 So, here was a case where 0:18:20.339,0:18:23.790 because of plasticity, people were inadvertently rewiring 0:18:24.479,0:18:25.300 their brains. 0:18:25.310,0:18:30.900 And plasticity isn't always a good thing. That it can lead to rigid behaviors (VOICE OVERLAP). 0:18:31.170,0:18:35.560 And in this case, it leads typically or very frequently to a kind of an addiction. 0:18:35.569,0:18:39.099 And if you think about it, addictions are about plastic change in the brain. 0:18:39.469,0:18:42.500 There are certain people who, if they have alcohol, 0:18:42.949,0:18:44.760 they have a chemical 0:18:45.050,0:18:48.589 sequence that's fired in their brain and a chemical called delta 0:18:48.709,0:18:48.780 FosB 0:18:49.050,0:18:50.540 is released 0:18:50.880,0:18:53.439 that changes their brain permanently. 0:18:53.520,0:18:56.310 That's why sometimes it does make sense for a person to say, 0:18:56.550,0:18:59.810 even though they haven't had a drink for years, I'm an alcoholic. 0:18:59.819,0:19:01.579 It's in plasticity terms, 0:19:01.589,0:19:06.079 my brain has been structurally altered by my interactions with alcohol. 0:19:06.510,0:19:11.079 Now, interesting you say that because they also point out that psychoanalysis 0:19:11.500,0:19:12.540 can be used 0:19:12.689,0:19:16.180 to open up the brain's pathways and reorder 0:19:16.569,0:19:20.069 the brain's function too. I think you call this 0:19:20.349,0:19:22.339 neuroplastic therapy. 0:19:22.689,0:19:26.030 Explain to me what that is and how it would work. 0:19:26.040,0:19:29.540 It turns out, you know, based on what I told you before about, 0:19:29.969,0:19:32.729 you know, thoughts altering genetic behavior 0:19:32.739,0:19:37.030 that thoughts in therapy are actually changing brain structure as well. 0:19:37.199,0:19:38.849 They change different brain structures. 0:19:38.859,0:19:42.030 But the major therapists that we know that are successful 0:19:42.969,0:19:46.910 and that includes psychoanalytic therapies, cognitive behavioral therapies, 0:19:46.920,0:19:48.709 it's something called interpersonal therapy. 0:19:48.719,0:19:50.680 They're all for slightly different conditions, 0:19:51.150,0:19:51.709 all 0:19:51.869,0:19:55.780 rewire the brain, all change the balance in the brain's department. 0:19:55.890,0:19:56.510 So, 0:19:56.939,0:19:59.670 they are as every bit as biological, if you were 0:19:59.680,0:20:03.760 in intervention as the use of drugs and the advantage of psychotherapy is if 0:20:03.770,0:20:05.459 you don't absolutely need drugs. 0:20:05.829,0:20:07.989 And I want to say, I mean, I use drugs sometimes 0:20:08.180,0:20:09.579 but the advantage of them is 0:20:09.819,0:20:10.260 they 0:20:10.800,0:20:12.810 don't have as many side effects 0:20:13.140,0:20:14.540 in general. And, 0:20:14.790,0:20:16.260 if you think about it, drugs 0:20:17.189,0:20:20.930 as they are today are very blunt instruments, you take a pill and it goes 0:20:21.130,0:20:24.060 and it bays every cell in your brain and in fact, in your body, 0:20:24.069,0:20:25.979 and that's why we get so many side effects. 0:20:26.359,0:20:27.459 And it would be 0:20:27.699,0:20:31.260 to a certain extent, if you're using thoughts for the intervention, 0:20:31.270,0:20:32.760 you're like more like a micro surgeon 0:20:32.770,0:20:35.449 going into the thought patterns that are probably... 0:20:35.699,0:20:41.209 Do you know enough about the brain to be that precise in terms of psychiatry 0:20:41.219,0:20:42.540 and psychoanalysis. 0:20:42.550,0:20:45.430 In other words, if I make an interpretation about the meaning of behavior, do 0:20:45.439,0:20:46.459 I know where in the brain 0:20:46.469,0:20:47.010 it's going? 0:20:47.339,0:20:50.479 Well if we're treating, let's say an anxiety problem, right? 0:20:50.770,0:20:55.000 We now know that if you use psychoanalytic psychotherapy 0:20:55.160,0:20:55.719 and 0:20:56.130,0:20:58.040 you take a person before the therapy 0:20:58.430,0:20:58.939 and 0:20:59.310,0:20:59.819 you 0:21:00.040,0:21:02.880 take the thing that's making them anxious and you 0:21:02.890,0:21:04.800 make them think about it or attend to it, 0:21:04.969,0:21:09.189 the part of the brain that's likely to light up and trigger these 0:21:09.199,0:21:11.099 sort of bolts of anxiety. 0:21:11.469,0:21:14.750 And after they go through the therapy, if the therapy works, 0:21:15.020,0:21:17.800 those parts of the brain aren't triggered. Now you 0:21:17.810,0:21:21.609 have an absolutely horrifying statistic here about our generation, 0:21:21.619,0:21:22.380 the baby boomers, 0:21:22.390,0:21:27.560 those between 40 and 60 that they have over a 50% chance of reaching the age of 85, 0:21:27.949,0:21:32.030 and that 85-year-olds have a 47% chance of having Alzheimer's. 0:21:32.130,0:21:37.209 We're going to have a population full of dementia. I mean, what can baby boomers do 0:21:37.400,0:21:39.640 to enhance their brain power and ward off that disease? 0:21:40.420,0:21:40.640 Okay. 0:21:40.650,0:21:42.979 So, there's two things that we worry about when 0:21:42.989,0:21:45.209 we think of mental decline as we get older. 0:21:45.489,0:21:48.890 One of them is a more benign thing and more common, 0:21:48.900,0:21:50.979 it's called age-related cognitive decline. 0:21:51.290,0:21:54.109 The senior moments that begin in our 50s that 0:21:54.349,0:21:55.569 frighten people 0:21:56.189,0:21:59.709 and then there are the serious dementias. 0:22:00.569,0:22:03.469 So, the good news is that we know for a fact 0:22:03.479,0:22:08.329 now that age-related cognitive decline is reversible through brain exercises. 0:22:08.339,0:22:09.810 And I met with a man Stanley 0:22:10.030,0:22:11.209 Karansky who was 90, 0:22:11.550,0:22:13.520 who started to have some difficulties 0:22:13.650,0:22:16.390 with senior moments. His handwriting was sloppy. 0:22:16.400,0:22:19.329 He was no longer alert, he wasn't socializing much. 0:22:19.869,0:22:20.339 And 0:22:20.500,0:22:21.459 in six weeks 0:22:22.359,0:22:22.520 and 0:22:22.729,0:22:22.739 roughly 0:22:22.849,0:22:25.449 an hour a day, he was able to reverse all of that. What was he doing? 0:22:26.099,0:22:29.280 He was doing a program called Posit Science that I described in the book. 0:22:29.290,0:22:31.079 Now, this is a company, an actual company. 0:22:31.219,0:22:34.500 Yeah. Tell me more about because you have been claiming like 80-year-olds to be like 50-year-olds. 0:22:34.819,0:22:35.849 Well, they've shown it. 0:22:35.859,0:22:39.489 Posit Science was set up by perhaps 0:22:39.500,0:22:41.489 the world's leading neuroplastician and 0:22:41.500,0:22:43.800 neuroplasticity researcher, Michael Merzenich. 0:22:44.349,0:22:44.979 And, 0:22:45.239,0:22:48.959 he's already a man of great accomplishment. He was one of 0:22:48.969,0:22:52.260 the inventors of the cochlear implant that allows the deaf to hear. 0:22:52.270,0:22:52.709 He's 0:22:52.890,0:22:55.380 helped kids with learning disabilities, 0:22:56.510,0:22:58.709 with reading disabilities, 0:22:58.979,0:23:03.180 moved from problems to basically normal or above normal levels. 0:23:03.430,0:23:06.319 And they set up a program that rebuilds 0:23:06.750,0:23:08.119 the auditory cortex, 0:23:08.130,0:23:12.920 the part of the brain that processes language from scratch in older people. 0:23:12.930,0:23:18.180 What happens is that we age. One of the reasons that we cannot remember things 0:23:18.430,0:23:19.250 is 0:23:20.349,0:23:22.780 our brain maps for sounds 0:23:22.939,0:23:24.979 are just kind of getting dulled. 0:23:24.989,0:23:28.900 They need to be tuned up at the very basic level of distinguishing sounds like "ba 0:23:29.060,0:23:29.459 and da 0:23:29.660,0:23:30.199 and pa." 0:23:31.290,0:23:34.709 The reason is we haven't really used them intensively 0:23:35.250,0:23:39.270 often. Once, we hit middle age, we are usually replaying, mastered skills. 0:23:39.280,0:23:41.089 But to maintain a brain in good shape, 0:23:41.160,0:23:42.949 you've got to work as hard as you worked when 0:23:42.959,0:23:45.209 you were learning a French vocabulary in high school, 0:23:45.219,0:23:48.069 maybe you didn't work at it, but as hard as you should have worked at. 0:23:48.780,0:23:51.699 And so people go for decades without 0:23:51.709,0:23:54.150 putting themselves for that intensive kind of training 0:23:54.479,0:23:54.910 and 0:23:55.829,0:23:57.540 the cortex just kind of gets 0:23:57.699,0:24:00.579 dull and you develop what are called fuzzy engrams. 0:24:00.589,0:24:04.420 You don't hear the sound of the person's name at the party crisply, 0:24:04.660,0:24:08.579 so they rebuild it from the ground up. How would our viewers get this program? 0:24:08.780,0:24:11.969 Posit Science. 0:24:12.119,0:24:15.410 Just go to put that in the internet and you'll come to the website for that. 0:24:15.689,0:24:18.760 What do you think the next big breakthrough is in brain research? 0:24:18.770,0:24:20.890 What's the next big thing we should be watching for? 0:24:22.199,0:24:24.699 It's the translation of the fundamental laws 0:24:24.709,0:24:29.250 of brain plasticity into applications for everything 0:24:29.839,0:24:34.319 in therapeutics, in all kinds of training, you know, that means sports, 0:24:34.660,0:24:38.979 the military education, anything you want to do and develop 0:24:39.109,0:24:39.979 Right 0:24:40.290,0:24:40.819 now 0:24:41.319,0:24:42.260 basically 0:24:42.589,0:24:47.390 many of these disciplines have an intuitive grasp of some of the laws of plasticity, 0:24:47.560,0:24:50.579 but the neuroplasticians can help sharpen and speed up learning. 0:24:51.130,0:24:51.729 So 0:24:52.000,0:24:53.400 that's where I imagine it would come. 0:24:53.410,0:24:54.579 I know that people will want to get 0:24:54.589,0:24:58.000 very highfalutin and try to facilitate neuroplastic change 0:24:58.410,0:25:01.619 with chemicals and some of that might be doable. 0:25:01.750,0:25:04.020 But that's also very problematic for the reason I 0:25:04.030,0:25:06.209 said that chemicals are still a very blunt instrument. 0:25:06.859,0:25:07.859 At a personal level, 0:25:07.869,0:25:10.180 I mean that this book is full of very, 0:25:10.189,0:25:13.619 not just amazing but inspirational and uplifting stories. 0:25:13.630,0:25:13.869 I mean, 0:25:14.060,0:25:15.719 over the course of doing the research, 0:25:15.729,0:25:18.180 did it kind of change your sense of what 0:25:18.189,0:25:20.699 human potential and perhaps even human nature is? 0:25:20.709,0:25:21.540 Yes, it did. 0:25:21.550,0:25:23.900 One of the most important insights I think I had 0:25:23.910,0:25:26.719 while doing the book was what I call the "plastic paradox," 0:25:26.729,0:25:27.619 and that is this. 0:25:28.089,0:25:29.250 The plasticity, 0:25:29.359,0:25:31.069 the brain is always plastic, 0:25:31.079,0:25:34.910 but it can give rise to both flexible or rigid behaviors. 0:25:34.920,0:25:39.030 It can give rise to rigid behaviors because once those networks are established, 0:25:40.189,0:25:40.660 they 0:25:40.819,0:25:43.060 tend to out compete the other one in a 0:25:43.069,0:25:45.290 war of nerves that's going on inside our head. 0:25:45.489,0:25:48.260 You know, the human brain is a habit-forming thing. 0:25:48.510,0:25:48.979 So, 0:25:49.849,0:25:53.189 the way to understand plasticity is think of it as like a hill, 0:25:53.560,0:25:57.819 snow on a hill in winter, and we want to ski down that hill, 0:25:57.829,0:26:00.959 so we get to the top of it. Because the snow is plastic or pliable, 0:26:00.969,0:26:02.790 we can take many paths down that hill, 0:26:03.270,0:26:04.170 but it being a hill, 0:26:04.180,0:26:08.609 it has rocks and trees and we be inclined towards certain favorite paths. 0:26:09.410,0:26:10.699 As we 0:26:10.939,0:26:12.750 keep using those paths 0:26:12.880,0:26:16.420 again precisely because the snow is pliable and plastic, 0:26:16.430,0:26:18.359 we'll develop tracks and ruts. 0:26:18.829,0:26:20.540 And what we do in our lives 0:26:20.550,0:26:25.109 and what we tend to think that because we're stuck in a rut 0:26:25.959,0:26:27.140 and repeating something 0:26:27.589,0:26:31.140 that not only is the behavior rigid, but the underlying brain is rigid. 0:26:31.290,0:26:32.989 So when I'm working with patients, 0:26:33.239,0:26:36.180 I try not to get fooled by the plastic paradox and 0:26:36.189,0:26:38.920 they're often fooled by the plastic paradox and I would submit 0:26:39.449,0:26:39.979 that 0:26:40.160,0:26:43.859 all of humanity to a large degree has been fooled by the plastic paradox. 0:26:43.869,0:26:45.530 I think we've underestimated 0:26:45.640,0:26:47.430 how plastic our brains really are. 0:26:48.069,0:26:50.469 Doctor Norman Doidge, I want to thank you very much for joining me. 0:26:50.479,0:26:52.849 It's been fascinating and a real pleasure. Thank you.