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For years she had tried to be the perfect wife and mother but now,
divorced, with two sons, having gone through another break-up and
in despair about her future, she felt as if she’d failed at it all,
and she was tired of it. On 6 June 2007 Debbie Hampton, of
Greensboro, North Carolina, took an overdose. That afternoon, she’d
written a note on her computer: “I’ve screwed up this life so bad
that there is no place here for me and nothing I can contribute.”
Then, in tears, she went upstairs, sat on her bed, and put on a
Dido CD to listen to as she died.
But then she woke up again. She’d been found, rushed to hospital,
and saved. “I was mad,” she says. “I’d messed it up. And, on top of
that, I’d brain-damaged myself.” After Debbie emerged from her
one-week coma, her doctors gave her their diagnosis:
encephalopathy. “That’s just a general term which means the brain’s
not operating right,” she says. She couldn’t swallow or control her
bladder, and her hands constantly shook. Much of the time, she
couldn’t understand what she was seeing. She could barely even
speak. “All I could do was make sounds,” she says. “It was like my
mouth was full of marbles. It was shocking, because what I heard
from my mouth didn’t match what I heard in my head.” After a stay
in a rehabilitation centre, she began recovering slowly. But, a
year in, she plateaued. “My speech was very slow and slurred. My
memory and thinking was unreliable. I didn’t have the energy to
live a normal life. A good day for me was emptying the
dishwasher.”
It was around this time that she tried a new treatment called
neurofeedback. She was required to have her brain monitored while
playing a simple Pac-Man-like game, controlling movements by
manipulating her brain waves. “Within ten sessions, my speech
improved.” But Debbie’s real turnaround happened when her
neurofeedback counsellor recommended a book: the international
bestseller
The Brain that Changes Itself by
Canadian psychotherapist Norman Doidge. “Oh my God,” she says. “For
the first time it really showed me it was possible to heal my
brain. Not only that it was possible, that it was up to me.”
After reading Doidge’s book, Debbie began living what she calls a
“brain-healthy” life. That includes yoga, meditation,
visualisation, diet and the maintenance of a positive mental
attitude. Today, she co-owns a yoga studio, has written an
autobiography and a guide to “brain-healthy living” and runs the
website thebestbrainpossible.com. The science of neuroplasticity,
she says, has taught her that, “You’re not stuck with the brain
you’re born with. You may be given certain genes but what you do in
your life changes your brain. And that’s the magic wand.”
Neuroplasticity, she says, “allows you to change your life and make
happiness a reality. You can go from being a victim to a victor.
It’s like a superpower. It’s like having X-ray vision.”
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Debbie’s not alone in her enthusiasm for neuroplasticity, which is
what we call the brain’s ability to change itself in response to
things that happen in our environment. Claims for its benefits are
widespread and startling. Half an hour on Google informs the
curious browser that neuroplasticity is a “magical” scientific
discovery that shows that our brains are not hard-wired like
computers, as was once thought, but like “play-doh” or a “gooey
butter cake”. This means that “our thoughts can change the
structure and function of our brains” and that by doing certain
exercises we can actually, physically increase our brain’s
“strength, size and density”. Neuroplasticity is a “series of
miracles happening in your own cranium” that means we can be better
salespeople and better athletes, and learn to love the taste of
broccoli. It can treat eating disorders, prevent cancer, lower our
risk of dementia by 60 per cent and help us discover our “true
essence of joy and peace”. We can teach ourselves the “skill” of
happiness and train our brains to be “awesome”. And age is no
limitation: neuroplasticity shows that “our minds are designed to
improve as we get older”. It doesn’t even have to be difficult.
“Simply by changing your route to work, shopping at a different
grocery store, or using your non-dominant hand to comb your hair
will increase your brain power.” As the celebrity
alternative-medicine guru Deepak Chopra has said, “Most people
think that their brain is in charge of them. We say we are in
charge of our brain.”
Debbie’s story is a mystery. The techniques promising to change her
brain via an understanding of the principles of neuroplasticity
have clearly had tremendous positive effects for her. But is it
true that neuroplasticity is a superpower, like X-ray vision? Can
we really increase the weight of our brain just by thinking? Can we
lower our risk of dementia by 60 per cent? And learn to love
broccoli?
Some of these seem like silly questions, but some of them don’t.
That’s the problem. It’s hard, for the non-scientist, to understand
what exactly neuroplasticity is and what its potential truly is.
“I’ve seen tremendous exaggeration,” says Greg Downey, an
anthropologist at Macquarie University and co-author of the popular
blog Neuroanthropology. “People are so excited about
neuroplasticity they talk themselves into believing
anything.”
————————我是必须翻译结束的分割线————————
§
For many years, the consensus was that the human brain couldn’t
generate new cells once it reached adulthood. Once you were grown,
you entered a state of neural decline. This was a view perhaps most
famously expressed by the so-called founder of modern neuroscience,
Santiago Ramón y Cajal. After an early interest in plasticity, he
became sceptical, writing in 1928, “In adult centres the nerve
paths are something fixed, ended, immutable. Everything may die,
nothing may be regenerated. It is for the science of the future to
change, if possible, this harsh decree.” Cajal’s gloomy prognosis
was to rumble through the 20th century.
Although the notion that the adult brain could undergo significant
positive changes received sporadic attention, throughout the 20th
century, it was generally overlooked, as a young psychologist
called Ian Robertson was to discover in 1980. He’d just begun
working with people who had had strokes at the Astley Ainslie
Hospital in Edinburgh, and found himself puzzled by what he was
seeing. “I’d moved into what was a new field for me,
neuro-rehabilitation,” he says. At the hospital, he witnessed
adults receiving occupational therapy and physiotherapy. Which made
him think… if they’d had a stroke, that meant a part of their brain
had been destroyed. And if a part of their brain had been
destroyed, everyone knew it was gone for ever. So how come these
repetitive physical therapies so often helped? It didn’t make
sense. “I was trying to get my head around, what was the model?” he
says. “What was the theoretical basis for all this activity here?”
The people who answered him were, by today’s standards,
pessimistic.
“Their whole philosophy was compensatory,” Robertson says. “They
thought the external therapies were just preventing further
negative things happening.” At one point, still baffled, he asked
for a textbook that explained how it all was supposed to work.
“There was a chapter on wheelchairs and a chapter on walking
sticks,” he says. “But there was nothing, absolutely nothing, on
this notion that the therapy might actually be influencing the
physical reconnection of the brain. That attitude really went back
to Cajal. He really influenced the whole mindset which said that
the adult brain is hardwired, all you can do is lose neurons, and
that if you have brain damage all you can do is help the surviving
parts of the brain work around it.”
But Cajal’s prognosis also contained a challenge. And it wasn’t
until the 1960s that the “science of the future” first began to
rise to it. Two stubborn pioneers, whose tales are recounted so
effectively in Doidge’s bestseller, were Paul Bach-y-Rita and
Michael Merzenich. Bach-y-Rita is perhaps best known for his work
helping blind people ‘see’ in a new and radically different way.
Rather than receiving information about the world from the eyes, he
wondered if they could take it in in the form of vibrations on
their skin. They’d sit on a chair and lean back on a metal sheet.
Pressing up against the back side of that metal sheet were 400
plates that would vibrate in accord with the way an object was
moving. As Bach-y-Rita’s devices became more sophisticated (the
most recent version sits on the tongue), congenitally blind people
began to report having the experience of ‘seeing’ in three
dimensions. It wasn’t until the advent of brain-scanning technology
that scientists began to see evidence for this incredible
hypothesis: that information seemed to be being processed in the
visual cortex. Although this hypothesis is yet to be firmly
established, it seems as if their brains had rewired themselves in
a radical and useful way that had long been thought
impossible.
Merzenich, meanwhile, helped to confirm in the late 1960s that the
brain contains ‘maps’ of the body and the outside world, and that
these maps have the ability to change. Next, he co-developed the
cochlear implant, which helped deaf people hear. This relies on the
principle of plasticity, as the brain needs to adapt to receive
auditory information from the artificial implant instead of the
cochlea (which, in the deaf person, isn’t working). In 1996 he
helped establish a commercial company that produces educational
software products called Fast ForWord for “enhancing the cognitive
skills of children using repetitive exercises that rely on
plasticity to improve brain function,” according to their website.
As Doidge writes, “In some cases, people who have had a lifetime of
cognitive difficulties get better after only thirty to sixty hours
of treatment.”
Although it took several decades, Merzenich and Bach-y-Rita were to
help prove that Cajal and the scientific consensus were wrong. The
adult brain was plastic. It could rewire itself, sometimes
radically. This came as a surprise to experts like Robertson, now a
Director of Trinity College Dublin’s Institute of Neuroscience. “I
can look back on giving lectures at Edinburgh University to
students where I gave wrong information, based on the dogma which
said that, once dead, a brain cell cannot regenerate and plasticity
happens in early childhood but not later,” he says.
It wasn’t until the publication of a series of vivid studies
involving brain scans that this new truth began to be encoded into
the synapses of the masses. In 1995, neuropsychologist Thomas
Elbert published his work on string players that showed the ‘maps’
in their brain that represented each finger of the left hand –
which they used for fingering – were enlarged compared to those of
non-musicians (and compared to their own right hands, not involved
in fingering). This demonstrated their brains had rewired
themselves as a result of their many, many, many hours of practice.
Three years later, a Swedish–American team, led by Peter Eriksson
of Sahlgrenska University Hospital, published a study in
Nature that showed, for the very first time,
that neurogenesis – the creation of new brain cells – was possible
in adults. In 2006, a team led by Eleanor Maguire at the Institute
of Neurology at University College London found that the city’s
taxi drivers have more grey matter in one hippocampal area than bus
drivers, due to their incredible spatial knowledge of London’s maze
of streets. In 2007, Doidge’s
The Brain that Changes
Itself was published. In its review of the book, the
New York Times proclaimed that “the power of
positive thinking has finally gained scientific credibility”. It
went on to sell over one million copies in over 100 countries.
Suddenly, neuroplasticity was everywhere.
§
It’s easy, and perhaps even fun, to be cynical about all this. But
neuroplasticity really is a remarkable thing. “What we do know is
that almost everything we do, all our behaviour, thoughts and
emotions, physically change our brains in a way that is underpinned
by changes in brain chemistry or function,” says Robertson.
“Neuroplasticity is a constant feature of the very essence of human
behaviour.” This understanding of the brain’s power, he says, opens
up new techniques for treating a potentially spectacular array of
illnesses. “There’s virtually no disease or injury, I believe,
where the potential doesn’t exist for very intelligent application
of stimulation to the brain via behaviour, possibly combined with
other stimulation.”
Does he agree that the power of positive thinking has now gained
scientific credibility? “My short answer is yes,” he says. “I do
think human beings have much more control over their brain function
than has been appreciated.” The long answer is: yes, but with
caveats. First there’s the influence of our genes. Surely, I ask
Robertson, they still hold a powerful influence over everything
from our health to our character? “My own crude rule of thumb is a
50–50 split in terms of the influence of nature and that of
nurture,” he says. “But we should be very positive about that 50
per cent that’s environmental.”
Adding extra tangle to the already confused public discussion of
neuroplasticity is the fact that the word itself can mean several
things. Broadly, says Sarah-Jayne Blakemore, Deputy Director of
London’s Institute of Cognitive Neuroscience, it refers to “the
ability of the brain to adapt to changing environmental stimuli”.
But the brain can adapt in many different ways. Neuroplasticity can
refer to structural changes, such as when neurons are created or
die off or when synaptic connections are created, strengthened or
pruned. It can also refer to functional reorganisations, such as
those experienced by the blind patients of Paul Bach-y-Rita, whose
contraptions triggered their brains to start using their visual
cortices, which had previously been redundant.
On the larger, developmental scale, there are two categories of
neuroplasticity. They are “really different,” says Blakemore. “You
need to differentiate between them.” Throughout childhood our
brains undergo a phase of ‘experience-expectant’ plasticity. They
‘expect’ to learn certain important things from the environment, at
certain stages, such as how to speak. Our brains don’t finish
developing in this way until around our mid-20s. “That’s why car
insurance premiums are so high for people under 25,” says
Robertson. “Their frontal lobes aren’t fully wired up to the rest
of their brains until then. Their whole capacity for anticipating
risk and impulsivity isn’t there.” Then there’s
‘experience-dependent’ plasticity. “That’s what the brain does
whenever we learn something, or whenever something changes in the
environment,” says Blakemore.
One way in which science has been exaggerated has been by the
blending of these different types of change. Some writers have made
it seem as if almost anything counts as ‘neuroplasticity’, and
therefore revolutionary and magical and newsworthy. But it’s
definitely not news, for example, that the brain is highly affected
by its environment when we’re young. Nevertheless, in
The
Brain that Changes Itself Norman Doidge observes the
wide variety of human sexual interests and calls it “sexual
plasticity”. Neuroscientist Sophie Scott, Deputy Director of
London’s Institute of Cognitive Neuroscience, is dubious. “That’s
just the effect of growing up on your brain,” she says. Doidge even
uses neuroplasticity to explain cultural changes, such as the broad
acceptance in the modern age that we marry for romantic love,
rather than socioeconomic convenience. “That isn’t
neuroplasticity,” says Scott.
This, then, is the truth about neuroplasticity: it does exist, and
it does work, but it’s not a miracle discovery that means that,
with a little effort, you can turn yourself into a broccoli-loving,
marathon-running, disease-immune, super-awesome genius. The “deep
question”, says Chris McManus, Professor of Psychology and Medical
Education at University College London, is, “Why do people, even
scientists, want to believe all this?” Curious about the underlying
causes of the neuroplasticity craze, he believes it is just the
latest version of the personal-transformation myth that’s been
haunting the culture of the West for generations.
§
“People have all sorts of dreams and fantasies and I don’t think
we’re very good at achieving them,” says McManus. “But we like to
think that when somebody is unsuccessful in life they can transform
themselves and become successful. It’s Samuel Smiles, isn’t it?
That book he wrote,
Self-Help, was the positive
thinking of Victorian times.”
Samuel Smiles [Full disclosure: Samuel Smiles is my
great-great-uncle] is commonly cited as the inventor of the
’self-help’ movement and his book, just like Doidge’s, spoke to
something deep in the population and became a surprise bestseller.
The optimistic message Smiles delivered spoke of both the new,
modern world and the dreams of the men and women living in it. “In
the 18th century, power had all been about the landed gentry,” says
historian Kate Williams. “Smiles was writing in the era of the
Industrial Revolution, widespread education and economic
opportunities offered by Empire. It was the first time a
middle-class man could work hard and do well. They needed a
formidable work ethic to succeed, and that’s what Smiles codified
in
Self-Help.”
In the latter part of the 19th century, US thinkers adapted this
idea to reflect their national belief that they were creating a new
world. Adherents of the New Thought, Christian Science and
Metaphysical Healing movements stripped away much of the talk of
hard work, insisted upon by the Brits, to create the positive
thinking movement to which some believe neuroplasticity has given
scientific credence. Psychologist William James called it “the
mind-cure movement”, the “intuitive belief in the all-saving power
of healthy-minded attitudes as such, in the conquering efficacy of
courage, hope, and trust, and a correlative contempt for doubt,
fear, worry, and all nervously precautionary states of mind”. Here
was the inherently American notion that self-confidence and
optimism – thoughts themselves – could offer personal
salvation.
This myth – that we can be whoever we want to be, and achieve our
dreams, as long as we have sufficient self-belief – emerges again
and again, in our novels, films and news, and TV singing
competitions featuring Simon Cowell, as well as unexpected crazes
like that for neuroplasticity. One previous, and remarkably
similar, incarnation was Neuro-Linguistic Programming, which had it
that psychological conditions such as depression were nothing more
than patterns learned by the brain and that success and happiness
were just a matter of reprogramming it. The idea appeared in a more
academic costume, according to McManus, in the form of what’s known
as the Standard Social Science Model. “This is the idea from the
1990s where, in effect, all human behaviour is infinitely malleable
and genes play no role at all.”
But the plasticity boosters have an answer to the tricky question
of genes, and their heavy influence over all matters of health,
life and wellbeing. Their answer is epigenetics. This is the
relatively new understanding of the ways in which the environment
can change how genes express themselves. Deepak Chopra has said
that epigenetics has shown us that, “regardless of the nature of
the genes we inherit from our parents, dynamic change at this level
allows us almost unlimited influence on our fate”.
Jonathan Mill, Professor of Epigenetics at the University of
Exeter, dismisses this kind of claim as “babble”. “It’s a really
exciting science,” he says, “but to say these things are going to
totally rewire your whole brain and gene functioning is taking it
far too far.” And it’s not just Chopra, he adds. Broadsheet
newspapers and academic journals have also been guilty, at times,
of falling for the myth. “There have been all sorts of amazingly
overhyped headlines. People who have been doing epigenetics for a
while are almost in despair, at the moment, partly because it’s
being used as an explanation for all sorts of things without any
real direct evidence.”
§
Just as epigenetics doesn’t fulfil our culture’s promise of
personal transformation, nor does neuroplasticity. Even some of the
more credible-sounding claims are, according to Ian Robertson,
currently unjustifiable. Take the one about reducing our risk of
dementia by 60 per cent. “There is not a single scientific study
that has ever shown that any intervention of any kind can reduce
the risk of dementia by 60 per cent, or indeed by any percentage,”
he says. “No one has done the research using appropriate
control-group methodologies to show that there is any
cause-and-effect link.”
Indeed, the clinical record for many famous treatments that use the
principles of neuroplasticity is notably mixed. In June 2015, the
Food and Drug Administration in the US permitted the marketing of
the latest iteration of Bach-y-Rita’s on-the-tongue ‘seeing’
devices for the blind, citing successful studies. And yet a 2015
Cochrane Review of constraint induced movement therapy – a
touchstone treatment for neuroplasticity evangelists that offers
improvements in motor function for people who have had a stroke –
found that “these benefits did not convincingly reduce disability”.
A 2011 meta-analysis of neuroplasticity Godfather Michael
Merzenich’s Fast ForWord learning techniques, described to such
thrilling effect by Doidge, found “no evidence” that they were
“effective as a treatment for children’s oral language or reading
difficulties”. This, according to Sophie Scott, goes for other
treatments too. “There’s been a lot of excitement about
brain-training packages and, actually, big studies of those tend
not to show very much effect,” she says. ”Or they show you’ve got
better at the thing you’ve practised at, but it doesn’t generalise
to something else.” In November 2015, a team lead by Clive Ballard
at King’s College London found some evidence that online
brain-training games might help reasoning, attention and memory in
the over-50s.
It’s perhaps understandable why crazy levels of hope are raised
when people read tales of apparently miraculous recovery from brain
injury that feature people seeing again, hearing again, walking
again and so on. These dramatic accounts can make it sound as if
anything is possible. But what’s usually being
described, in these instances, is a very specific form of
neuroplasticity – functional reorganisation – which can happen only
in certain circumstances. “The limits are partly architectural,”
says Greg Downey. “Certain parts of the brain are better at doing
certain kinds of thing, and part of that comes simply from where
they are.”
Another limitation, for the person hoping to develop a superpower,
is the simple fact that every part of a normal brain is already
occupied. “The reason you get reorganisation after an amputation,
for example, is that you’ve just put into unemployment a section of
the somatosensory cortex,” he says. A healthy brain just doesn’t
have this available real estate. “Because it keeps getting used for
what it’s being used for, you can’t train it to do something else.
It’s already doing something.”
Age, too, presents a problem. “Over time, plastic sets,” says
Downey. “You start off with more of it and space for movement
slowly decreases. That’s why a brain injury at 25 is a total
different ballgame to a brain injury at seven. Plasticity says you
start off with a lot of potential but you’re laying down a future
that’s going to become increasingly determined by what you’ve done
before.”
Robertson speaks of treating a famous writer and historian who’d
had a stroke. “He completely lost the capacity for all expressive
language,” he says. “He couldn’t say a word, he couldn’t write. He
had a huge amount of therapy and no amount of stimulation could
really recover that because the brain had become hyper-specialised
and a whole network had developed for the highly refined production
of language.” Despite what the currents of our culture might
insistently beckon us towards believing, the brain is not Play-Doh.
“You can’t open up new areas of it,” says McManus. “You can’t
extend it into different parts. The brain isn’t a mass of grey
gloop. You can’t do anything you like.”
Even the people whose lives are being transformed by
neuroplasticity are finding that brain change is anything but easy.
Take recovery from a stroke. “If you’re going to recover the use of
an arm, you may need to move that arm tens of thousands of times
before it begins to learn new neural pathways to do that,” says
Downey. “And, after that, there’s no guarantee it’s going to work.”
Scott says something similar about speech and language therapy.
“There were dark days, say, 50 years ago, where if you’d had a
stroke you didn’t get that kind of treatment other than to stop you
choking because they’d decided it doesn’t work. But now it’s
becoming absolutely clear that it does, and that it’s a
phenomenally good thing. But none of it comes for free.”
Those who over-evangelise emerging disciplines like neuroplasticity
or epigenetics can sometimes be guilty of talking as if the
influence of our genes no longer matters. Their enthusiasm can make
it seem, to the non-specialist, as if nurture can easily conquer
nature. This is a story that attracts people in great numbers, to
newspapers, blogs and gurus, because it’s one our culture
reinforces, and one we want to believe: that radical personal
transformation is possible, that we have the potential to be
whoever and whatever we want to be, that we can find happiness,
success, salvation – all we need to do is try. We are dreamers down
to our very synapses, we are the people of the American
Dream.
Of course, it’s our malleable brains that have moulded themselves
to these rhythms. As we grow up, the optimistic myths of our
culture become so embedded in our sense of self that we can lose
touch with the fact that they are just myths. The irony is that
when scientists carefully describe the blind seeing and the deaf
hearing, and we hear it as talk of wild miracles, it’s the fault of
our neuroplasticity.