Reviewer Lynda Woodroffe
Last Spring, I was walking along some sunny country lanes with a friend who has suffered with Parkinson’s Disease (PD) for over ten years. She was using walking aids much like many other people who walk in hills and mountains, sticks that increase fitness by getting the arms to work as well as the legs. Usually we walk at an uncomfortable (for me) slow pace. Walking with her on this occasion meant that I didn’t have to slow down. She seemed to take longer strides than usual and have more control. I put that down to the use of the sticks.
Later that same evening, we were out with our partners. My friend gripped her husband’s arm and strode out with him in unison at a good pace. This was no mean feat and my partner and I noticed how we had to keep up with them, something we normally did not do.
My friend told me she had been using a technique she had found in a book about neuroplastic healing by Norman Doidge, an American psychiatrist and psychoanalyst. Neuroplasticity is what scientists call a phenomenon whereby, due to the changeable and flexible nature of neural tissue, some brain injury can be reversed. This is was what my friend with PD was attempting to do – to change the way her PD symptoms were affecting her life. She called this particular practice conscious walking and believed it brought about the creation of new pathways in the brain to enable the complicated movements of walking, which we who are well take for granted, to take place.
There are many questions relating to the cause of PD that have not been answered – yet. With PD, the motor nerve system is affected by a lack of dopamine (a neuro-transmitter); symptoms include the lack of motor control in many parts of the body including the face and vocal cords, often reducing the speed with which one can react, express oneself, process thoughts into speech, or cough, and it also affects sleep patterns. In this book, Doidge describes a way to overcome the lack of motor control, not as cure, but a method to manage it, by fast walking. He reports that the fast walking stimulates inactive neurones and creates better connections between the brain and the weakened muscles needed for walking (Doidge, 2015:78). He purports that continued practice in fast walking will bring about rapid change for those with PD symptoms. Changes like these, he calls neuroplasticity, not a new concept, but Doidge challenges the common view that there is no flexibility in the functions of the brain, and, therefore, not a lot of hope for people with PD.
He tells the story of a physicist, Moshe Feldenkrais (1904-1984), who hurt his knee while in his late twenties. The injury worsened over the years. Later on in his life, Feldenkrais injured his other leg. He noticed that in his original injury, the pain lessened and he was forced to use that leg. Feldenkrais wrote ‘acute trauma … led his brain to inhibit the motor cortex brain maps for that leg to protect it from further injury’. In his inception of the Feldenkrais Method for movement, he wrote: ‘No part of the body can be moved without all the others being affected’ and referred to his work as holistic in nature, much like the Alexander Technique; there is no division between mind and body, it is all connected (Feldenkrais in Doidge, 2015:165-166).
After reading the index, I bought Doidge’s book:
Chapter 1 Physician Hurt, Then Heal Thyself (Chronic Pain can be Unlearned) Chapter 2 A Man walks off his Parkinsonian Symptoms
Chapter 3 The Stages of Neuroplastic Healing
Chapter 4 Rewiring a Brain with Light
Chapter 5 Moshe Feldenkrais: Physicist, Black Belt and Healer
Chapter 6 A Blind Man learns to See
Chapter 7 A Device That Resets the Brain
Chapter 8 A Bridge of Sound (the special connection between music and the brain)
(Doidge, 2015, Index)
The ideas are not new; yogis (Siddhas) have long shown the power of mind over matter; hypnotists often claim to be able to reduce pain; body dysmorphia is not uncommon; people with anorexia see themselves in a mirror as a fat person. Doidge reports on a phenomenon that all of us who have had dental treatment may have experienced: ‘… when the dentist gives a local anaesthetic: suddenly the jaw and cheeks feel subjectively larger than they really are.’ (Doidge, 2015:22). Taking these examples into consideration, as far as I know yogis and hypnotists do not address specific diseases through mind control. In his book, Doidge provides some case studies from his research that do just this. One is of a young child, born prematurely and diagnosed with brain damage, who had faced difficulties in learning to walk and talk. Using ideas about how foetuses perceive their environment, Doidge reports improvements through listening therapy. Sounds were created like those that a foetus would hear – the muffled noises of the mother’s voice, other lower pitched sounds, like those in droning Gregorian chants, and some of Mozart’s concerti. Recordings of these sounds were used to stimulate the hearing part of the child’s brain. Doidge states that, in a matter of a few days, there were changes in the child’s mobility, cognitive ability, muscle tension and sleep rhythms.
The explanation, Doidge wrote, was that the sounds focused parts of the brain that were undamaged to compensate for the loss in other areas and to find new networks. He is not alone in the belief that this works. Many others working in the field believe this too and, apparently, seek evidence for their ideas through PET scans. Doidge joins two eminent psychoanalysts who preceded him in the belief that foetuses were sensitive; Winnicott believed that the unborn child ‘perceived and had feelings’ and Freud thought that birth ‘could be traumatic’ (Doidge, 2015:309). We know now from medical reports that, indeed, birth can be traumatic.
Doidge reports too, that listening therapy showed changes in children with dyslexia, autism and ADHD. Neuro-stimulation is the panacea, he asserts (Doidge, 2015:109-110). He backs his ideas with neuroscience records, showing activity in formerly inert parts of the brain. I am particularly interested in Chapter 1 on pain reduction, Chapter 2 about PD, and Chapter 8 which reports on the effects of listening therapy. This is because I have a client who suffers chronic pain, two friends with PD and relatives with dyslexia and mild autism.
One of the justifications of Doidge’s assertions is that he believes that the work of listening therapy has not received much attention because of the lack of understanding by medical researchers into the sub-cortex – which lies underneath the cortex – although that is difficult to believe (Doidge, 2015:318). Everyday activities are not enough to stimulate neurones to create new links, Doidge writes, but listening therapy addresses this (Doidge, 2015:313).
In describing how we feel pain, Doidge explains that synapses form joints in neurones which transmit neuro-transmitting chemicals, but that these, with less frequent use, become less active. Obviously, I thought.
Doidge also reports two different conditions for pain – acute (low number of active neurones) and chronic pain (high number of active neurones) and he describes how one scientist helps patients to shrink their pain through visualisation, touch, sound and vibration (Doidge, 2015:31). But when he wrote that the cells around an injury became more active and invite other areas to participate – resulting in inferred pain, he caused me to think about somatised emotional pain, something, as a psychotherapist, I have often encountered in my clients. Knowing more about the physiology of somatised pain is useful to me in my practice.
There is much to be said of Doidge’s assertions in this book, but he gives few examples. In terms of the medical model of research, his sample is too small to be of significance. So why should anyone take any notice?
First, personal experience has validity; it is not nothing to experience motor-control shutdown through brain malfunction and to learn new ways to address this, where, simultaneously, the medical world addresses it from another point of view. It offers hope and, it seems, practical methods of living with PD.
Second, although it does sound as though Doidge’s work is only accessible to a few wealthy individuals, that is not entirely true. Publishing his work makes it more accessible and, in countries where there is state-supported welfare, there do exist clinics, centres for movement, relaxation, speech therapy and physiotherapy free of charge for those who need it.
However, Doidge doesn’t write about failures. It is these that may not only put more balance into his reports, but which also may bring about insights into the practices written about. Where did they go wrong? What can be learned from failing? What new thoughts about the practices can be considered and where does serendipity fit in?
These are questions that need some attention; otherwise it could sound like dogma.
Lynda Woodroffe is an integrative psychotherapist practising in North-West London. She is also on the editorial board of Contemporary Psychotherapy.
Doidge, N. (2015) The Brain’s Way of Healing. Stories of remarkable recoveries and discoveries. Allen Lane: UK.
Feldenkrais, M. (1981) The Elusive Obvious Cupertino, CA: Meta Publications
Feldenkrais, M. (1985) The Potent Self: A guide to spontaneity San Francisco: Harper & Row
Winnicott, D. W. (1975) Through Paediatrics to Psychoanalysis in The International Pscho-analytical Library 100:174-93 London: The Hogarth Press