Book
Review
The Brain
that Changes Itself: Discovering the Science of Brain Plasticity
Brennon Dickson
Arkansas State University
Address correspondence to Brennon Dickson, Department of
Psychology & Counseling, PO Box 1560, State University,
Jonesboro, AR 72401 USA, e-mail:
brennon.dickson@smail.astate.edu
In
his book The Brain That Changes Itself: Stories of Personal
Triumph from the Frontiers of Brain Science, Norman Doidge, M.
D., delves deeply into the contemporary neuroscience of brain
plasticity. Doidge is a psychiatrist and psychoanalyst and works as
a researcher at the Columbia University Center for Psychoanalytic
Training and Research in New York and as a faculty member in the
University of Toronto’s Department of Psychiatry. His artistry with
words reflects the fact that he is a four-time recipient of Canada’s
National Magazine Gold Award, and his style of writing makes reading
his work possible for not only those with a graduate-level
understanding of the material, but also for those completely new to
the topic. The Brain That Changes Itself clocks in at only
285 pages, with an additional 142 pages of appendices, notes,
references, and index. It is divided into eleven chapters, each
dealing with a different aspect of brain plasticity.
The discovery of brain
plasticity is a recent and exciting development, and Doidge does an
excellent job covering all angles of the subject. Drawing on the
works of several leaders in the field, such as Paul Bach-y-Rita,
Aleksandr Luria, Mark Rosenzweig, Michael Merzenich, Edward Taub, V.
S. Ramachandran, Alvaro Pascual-Leone, and Eric Kandel, he provides
a detailed description of how brain plasticity works, its scientific
implications, and how research on plasticity may aid those with
impairments caused by Alzheimer’s disease, mental retardation,
stroke, obsessive-compulsive disorder, phantom limbs, and even
blindness. After reading each example of those who have harnessed
the power of brain plasticity to overcome tragedies in their lives,
it is hard not to become as excited as Doidge concerning the
possible benefits of future research.
Until very recently, it was
widely believed that the brain anatomy was fixed, or hard-wired, and
that after childhood, the brain only changed as it declined with
age. As a result, there was a common misconception that people with
brain damage or specific brain impairments couldn’t be helped in any
way. With the contemporary knowledge that the brain is plastic in
nature, we now know that damaged brains can reorganize themselves to
compensate and still function normally, we have a new understanding
of the impact that the environment can have on altering our brain
structure, and it is contested by many that dead brain cells can
even be replaced by new ones (Doidge, 2007).
Doidge lists four types of
plasticity as described by the research scientist Jordan Grafman:
1) Map expansion (occurs primarily
at boundaries between brain areas and results from daily activities)
2) Sensory reassignment
(occurs when one sense is impaired in some way and its sensory input
is relocated to another sense)
3) Compensatory masquerade
(the ability of the human brain to achieve certain functions in
several different ways)
4) Mirror region takeover (the
concept that when part of one hemisphere fails, the mirror region in
the opposite hemisphere changes to compensate)
He also strongly emphasizes both
Hebb’s Law (neurons that fire together wire together), and the
principle of “use it or lose it,” which together lay a strong
fundamental foundation for how neuroplasticity operates. Each
concept that he introduces is thoroughly described through
scientific interpretation and made easy to understand through the
inclusion of several real-life examples. In fact, it is these very
examples that make the book such a pleasurable and informative
read.
One story that Doidge includes
in the first chapter of the book describes a woman with a
dysfunctional vestibular apparatus (a sensory organ used for the
balance system) who feels as if she is perpetually falling, and as a
result, actually falls quite frequently. However, she soon consults
with Paul Bach-y-Rita, who has developed a device that he calls an
accelerometer, which replaces her vestibular apparatus and sends her
balance signals to her brain through stimuli on her tongue. Using
the device, she is soon able to train her brain to compensate for
the 95-100% loss of vestibular function, and she can easily navigate
the physical world without fear of falling and injuring herself.
This is an excellent example of how the plastic brain is capable of
re-organizing its neuronal pathways in beneficial ways.
Another story, found in chapter
2, details a mentally challenged woman with an impairment in Broca’s
area, limited spatial reasoning skills, kinesthetic dysfunction,
visual disability, and problems with grammar, math, and logic. By
independently studying (systematically reading and re-reading
difficult passages repetitively) the work of the neurophysiologist
Aleksandr Luria and Mark Rosenzweig’s work on neuroplasticity, she
was able to design her own unique mental exercises, improving her
cognitive functioning in all of the aforementioned areas. She later
went on to open the Arrowsmith School in Toronto, which utilizes
neuroplasticity-based techniques to help others overcome their own
weak brain functions.
Chapter 3 covers the remarkable
work of the neuroplastician Michael Merzenich, considered by many to
be the world’s foremost brain plasticity researcher. By mapping a
monkey’s hand map in its brain, amputating its middle finger, and
then several months later re-mapping the monkey’s brain, Merzenich
noticed that the map for the amputated finger was gone, being
replaced by the maps for each adjacent finger. This research shed
much light on Hebb’s Law and the idea of competitive plasticity.
Doidge also discusses Merzenich’s other extensive contributions to
brain science, which include the development of “Fast ForWord,” a
training program for children with language and learning
disabilities, and his founding of the company Posit Science, which
is devoted to helping people use plasticity to fight the adverse
effects of aging on mental functioning.
Another uplifting story, found
in chapter 7, describes a man who at the age of 17 lost his arm in a
car accident, yet suffered from the bizarre phenomenon called
“phantom limbs” thereafter. Those with phantom limbs still “feel”
their missing limbs, sometimes even feeling recurring pain in those
limbs. With the aid of the noted neurologist V. S. Ramachandran,
the man was able to “amputate” his phantom limb through the use of a
mirror box, which tricked his brain into re-wiring itself.
Ramachandran’s work in this area demonstrates how pain, feeling, and
body image are closely related, and illustrates how neuropathic pain
is processed in the brain.
Perhaps the most remarkable
story, highlighted in chapter 11, is that of Michelle Mack, a girl
who was born with only half of a brain. Lacking her entire left
hemisphere, Michelle’s right hemisphere was forced to compensate for
functions normally resigned to the left hemisphere, such as speech
and language functions. Despite her shocking limitation, she is
able to speak rather normally, enjoy daily activities such as
watching movies, and even read. She does show some physical signs
of her impairment, such as motor problems with her right side,
vision deficiencies from her right side, and a slightly bent and
twisted (but usable) right wrist, but the simple fact that she is
capable of functioning on a fairly normal level is staggering. Her
achievements in life are examples of the best that neuroplasticity
has to offer, and are an excellent depiction of the brain’s capacity
for massive reorganization.
These are just a few examples
selected from Doidge’s book, yet they reflect the feel and theme of
the work. There are several more fascinating stories to be found
within, such as how plasticity influences sexual preferences,
romantic love, and addiction, how constraint-induced movement
therapy is aiding those afflicted with cerebral palsy, spinal cord
injuries, Parkinson’s, Muscular Dystrophy, arthritis, and strokes,
and how we can enact plastic change through the simple use of our
imaginations. The book is replete with amazing facts and anecdotal
stories, and is an excellent introduction to the fascinating fields
of neuroscience and neuroplasticity.
The Brain That Changes
Itself is a highly-entertaining and informative read, and I
recommend this book to anyone who is curious about how the brain
operates. It is written in an informal fashion that should attract
even the most casual of readers, yet still manages to remain
informative. Blending a comprehensive understanding of the subject
matter with his impressive writing skills, Doidge has produced a
masterful book on the topic of brain plasticity. If you have an
interest in neuroscience, psychology, or human cognition, you won’t
be disappointed.
Doidge, N.
(2007). The brain that changes itself: Stories of personal
triumph from the frontiers of brain science. New York: Penguin
Books Ltd. ISBN: 978-0-670-03830-5 (hardcopy) or 978-0-14-311310-2
(paperback)
Accepted for
publication: 10 December 2008
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