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