What Book to Read?

Published in 2015, The Brain’s Way of Healing is a sequel to The Brain that Changes Itself (2007). Subtitled ‘remarkable discoveries and recoveries from the frontiers of neuroplasticity’, it continues the popularisation of the concept of the brain’s neuroplasticity described in the earlier book. Doidge, a doctor himself, is a skilled medical science communicator. I found what he had to say in the earlier book about how the brain can compensate and redirect was fascinating and exciting, as the concept that the brain is not a hardwired machine was new to me. This book looks at understanding and using healing techniques that make use of this neuroplasticity, the reality of which is now, Doidge considers, taken as a given by neurological research. I found it mostly interesting, but sometimes a bit preachy.

Each chapter is devoted to a particular condition that Doidge argues is amenable to a treatment that makes use of the brain’s inherent ability to repair itself. As in the earlier book, he uses a particular case study to illustrate how a specific treatment can ameliorate or even cure the patient’s symptoms and/or underlying problem. These problems include chronic pain, Parkinson’s disease, traumatic brain injury, multiple sclerosis, attention deficit disorder, learning difficulties and stroke. Doidge identifies four stages in the healing process: neurostimulation, which helps revive dormant circuits in a damaged brain; neuromodulation, which helps build new circuits and overcomes learned non-use in existing circuits; neurorelaxation, where the brain stores energy needed for regeneration; and neurodifferentiation and learning, where the brain’s circuits begin to regulate themselves and allow for normal functioning. The treatments all rely on this ‘rewiring’ of the brain by methods including visualisation, lasers, sound/music therapy, electrical stimulation and exercise both physical and mental, though he is essentially claiming there is no difference between the physical and the mental. (He approvingly quotes Moshe Feldenkrais, who wrote that ‘the unity of the mind and body is an objective reality. They are not just parts somehow related to each other, but an indispensable whole while functioning.’) He notes in an appendix that while he has linked one possible treatment to one problem, in practice some combination or sequence of treatments would usually be tried. He doesn’t claim that all – or indeed any – of the treatments will work for all people with these conditions, but argues that any or all are worth trying, as they have no adverse side effects, and often at least improve the situation where conventional treatments including surgery and medication do not.

The treatments – at least as practiced in the West – all seem to be the brainchild of a particular individual or small group of researchers, though some have roots in Eastern practice. No doubt Doidge is correct that neuroplasticity is now accepted science, but the practitioners he discusses all seem to be working on the margins of recognized practice. Some, indeed, such as Moshe Feldenkrais, worked on their treatments well before there was any understanding of the brain’s plasticity, an understanding which Doidge says now explains why their tratments work. I seem to remember that the early leaders in neuroplasticity were loners on the scientific frontiers, and presumably that’s how scientific breakthroughs are made. Doidge only includes examples that he has personal knowledge of, the researchers and practitioners that test the science often belong to well-regarded institutions, and there is a whole section of notes and references at the end of the book to which the sceptical can refer. He notes in the acknowledgements that his editor suffered a stroke part way through the publication process, and was told he wouldn’t recover much of his lost functioning, yet recovered sufficiently using techniques from the book to finish editing it (though I wish he’d put the picture of the brain at the front, not the back of the book). Some of the cures are, nevertheless, hard to believe.

And the response to the book has been mixed. One critical review, for example, concludes that ‘[t]hese cures and their emphasis on the patient’s willpower and moral fibre are, at best, bizarre’. Certainly some of the cases Doidge outlines involve highly motivated people who would not have succeeded without that motivation. As one of the patients says ‘you have to want it really badly’. The problem here is that someone else trying the technique, who for whatever reason lacks that will power, will feel themselves to blame if the treatment doesn’t produce results. And yes there can be a moral element to the judgement that they just didn’t try hard enough – victim blaming in other words. On the other hand, some of the treatments, for example those targeting learning difficulties, are designed to help children, and at least initially only require a passive response. It’s true that a number of the examples are cases of last resort but this is presumably because the techniques are new and not yet adopted by most mainstream doctors, who continue to offer treatment within the existing paradigm. A further concern is that such cures offer false hope to patients and their families. Doidge never says they are suitable for all people with the conditions he discusses, and emphasises that they are mostly not do-it-yourself remedies – they require skilled assessment and monitoring, which are resources in very short supply in most parts of the world. Nevertheless, his enthusiasm for the techniques would give hope to those with the conditions – but a hope probably unable to be fulfilled.

I was telling a friend about this book, and she asked why, if the techniques Doidge champions are so successful, are they so little used? Are they the sort of crazy stuff you might find on medical self-help sites on the internet? Have they been rigorously assessed and found wanting? Or will they, like the concept of neuroplasticity itself, become in time the new paradigm for the treatment of conditions affecting the brain? Time will tell.

You can read more about Dr Doidge and his work here. Here’s a rather less hostile review. And here’s one totally hostile one from a medical writer and parent of an autistic child (and yes Doidge does come close – dangerously in my view – to linking autism and vaccination). And here’s another totally hostile one from an evolutionary biologist who pulls no punches. Ah well, science thrives on controversy.