Brain Plasticity Arrives in Toronto OR Why Haven't I Heard of Neurofeedback?

Over breakfast this morning, I read a Toronto Star article by Judy Steed about brain plasticity and the Rotman Research Institute. While I was delighted to have the ability of the adult brain to change discussed in a very public place, I have to admit I experienced a resurgence of the frustration and annoyance I often get when I read about medical centres "discovering" plasticity.

I don't mean discovering in the sense of being the first to uncover the phenomenon.

Because they just aren't the first anymore.

I mean "discovering" in the sense of reporting on a phenomenon that is well-known in many circles and has been for some time, but announcing it as if they were the first. (Perhaps a bit like the claim that Europeans "discovered" the Americas which annoys our native peoples, but that's another article for someone else's blog ;-).

When I read these articles, it seems to me to come across as if these "centres of excellence" were finally uncovering critically important findings that everyone else has missed -- and taking the credit for it.

So this article is a bit of a rant - and I apologize in advance if I go over the top, but it is SO frustrating to be working in a field that has recognized the plasticity of the brain for decades and used that ability of the brain to change itself to help people for decades, only to have it dismissed for decades by many medical settings who are now "discovering" it without any mention of those there before them.

But let me back up a bit and be clear....

First, a quick review of what we mean by "brain plasticity"...

As Judy Steed correctly noted in her article, brain plasticity is the jargon for the ability of the brain to change, to re-organize itself (think plasticine - the kind of stuff kids play with to model new shapes, not plastic that's hard and permanent for eons). What research has been increasingly showing is that what we think and do and feel actually changes the structure of our brain, while the structure makes us more likely to think and feel and do what we have in the past.

Evidence has been accumulating about this for decades, but conventional medical wisdom has been that only the brain of a child is plastic and changeable, that once we get past certain early "critical periods", the adult brain can only experience death of brain cells through aging or injury. Damage or inefficiencies are permanent. As a neuropsychologist, I was trained in the 1970's and 1980's that we could only help people cope and "compensate" (do work-arounds, that is) for brain problems -- and many professionals seem to be still stuck in that perspective.

Behind the conventional scenes of academic medical centres and their journals, there was a great deal of accumulating evidence that the brain could and did change itself, recovering from injury, being to "re-wire" itself to recover from emotional trauma, mood disorders, headaches, chronic pain, etc, etc. These early brain plasticity researchers were ignored or their findings were called "impossible" and dismissed, their papers were refused for publication, not on the basis of their design or statistical analysis, but on the basis of their findings, which "couldn't be right".

In spite of the lack of interest from conventional medical folks, these researchers and innovative practitioners persevered to create a number of tecniques for enhancing the ability of the brain to change itself -- much of what today we refer to as "neurofeedback".

Neurofeedback services have been available since the 1960's to help people change their brain functioning, but health-care students are rarely taught about it and many medical practitioners still dismiss it.

A personal example:

When I started my neurofeedback practice, I sent a letter describing the use of pirHEG with migraines to every neurologist and family physician in my area of Toronto. I spelled out in a 1.5 page letter (they don't have time to read) a summary of who they might want to refer (i.e., the folks they hadn't been able to help for various reasons), what HEG was all about, and references to both clinical and basic research supporting the technique.

I got zero answers. None.

A while later, I had a client who was referred to one of these neurologists by her family physician for migraine treatment prior to her seeking out my services. By the time she got her appointment with him, we had managed to eliminate most of her migraines and significantly reduce the pain intensity of what was left. She was hopping mad that no one had told her about this neurofeedback option before -- offering her only medications that knocked her out -- and kept her appointment with the neurologist in order to do some education with him.

Both of us were surprised when he actually recognized the name of HEG. Nevertheless, he still was fairly dismissive of it (even though it was already effective for her!) and even told her I was using the "wrong technique" and what I should be doing instead -- I was even a bit alarmed by his willingness to "prescribe" outside of his own area of expertise. And, of course, he never referred anyone else to me for HEG.

Other examples of conventional medicine "not listening":

- the "discovery" of use of near-infrared technology to "see" brain functioning (and maybe "someday" as an intervention!) BUT the patent for this is already owned by a neurofeedback researcher and practitioner Dr. Hershel Toomin who uses near-infrared HEG for highly effective interventions

- the "discovery" that magnetic pulses can change brain function and investigating rTMS use in helping depression, anxiety, and other brain activity BUT Chuck Davis has already developed a magnetic pulse technology (pRoshi) used by many neurofeedback practitioners. This example is also typical of medical approaches in that it uses large magnetic fields for the "big, instant" effect rather than the smaller, less intrusive pulses used in the pRoshi technology.

- I recently assessed a young man suffering from phantom limb pain following the amputation of his leg. In spite of his severe pain, no one else had mentioned to him a more recent, innovative program called "mirror box therapy" which has had good results "re-training" the brain to respond differently to the missing limb and eliminating phantom limb pain. It has also been used with stroke and other pain conditions.

- Constraint-induced therapy is another effective intervention following stroke to increase functional use of paralyzed limbs, but I have yet to meet anyone with a stroke living in Toronto who has had this highly structured rehabilitation technique made available to them. (If you know of a place providing it in Toronto, plese do let me know!)

- The entire article today talking about brain plasticity and the medical facilities investigating it didn't mention once that there are therapies and training approaches already using priniciples of brain plasticity to create long-term, meaningful change for individuals who do their own research.

I have a full practice in Ontario providing services that use the principles of brain plasticity and not one of my clients was referred by a medical practitioner. What does that say?

Anyway -- next time, back to our interrupted program of ways you can use the principles of brain plasticity yourself to create change in your brain -- with or without access to neurofeedback equipment. Thanks for listening to my frustrations ;-)

(Now you know why I avoid answering the question everyone asks me: "This is so great! Why haven't I heard about this before?"....Best not to even get started ;-)

To learn more about plasticity, you might enjoy starting with The Brain That Changes Itself, by Dr. Norman Doidge.

In Canadian $:

In U.S. $:

Or feel free to google neurofeedback and browse any number of sites that pop up! The medical world isn't paying much attention (until they re-discover it perhaps ), but brain plasticity-based interventions are available right now.