The Woman Who Changed Her Brain: And Other Inspiring Stories of Pioneering Brain Transformation

INTRODUCTION

March 2, 1943, Vyazma, Western Russia

On this sunny, almost warm but damp day, the soldiers are chilled, their army-issue felt boots soaked. Lieutenant Lyova Zazetsky, just twenty-three years old, commands a platoon of flame-throwers—part of a contingent pushing back against the German invaders who are dug in atop the steep and rocky banks of the frozen Vorya River.

Comrade Zazetsky looks west, where they will soon be headed. He talks to his men, encouraging them while they all wait impatiently in the stillness, as they have for the past two days. Finally, the order comes to advance, and the only sound he hears now is the clank and screech of armor stirring. In a low crouch, Zazetsky moves across the river ice at a pace between walking and running when the enemy begins to fire. As he hears machine-gun bullets whizzing over his head, he drops down instinctively under the hail of artillery. Then he rises and presses on. Then nothing.

Zazetsky’s next memory is of coming to “in a tent blazing with light. . . . All I can remember is that the doctors and aides were holding me down. . . . I was screaming, gasping for breath. . . . Warm, sticky blood was running down my ears and neck. . . . My mouth and lips had a salty taste.” A bullet has penetrated his helmet, then his skull, and has done massive damage to the left occipito-parietal region of his brain, leading to a prolonged coma and severely affecting his ability to reason. With damage to this area, the world of making connections and understanding relationships is lost. Even after hours of patient explanation, Zazetsky cannot fathom that an elephant is bigger than a fly (he knows that one is big and one small but cannot grasp the relationship between the two; the words bigger and smaller confound him).

Later he is shown photos of variously colored cats and asked to state which is bigger and which smaller. This too is beyond him.

“Since I was wounded,” Zazetsky writes, “I’ve only been able to compare one word with another—one idea. And here there were so many different ideas that I got awfully confused.” Unable to see the relationships between things, he sees the world as separate parts. Even something as simple as connecting the big and little hand on a clock is now impossible. He no longer understands logic, cause and effect, grammar, or dialogue in a film. For Zazetsky, the words in a movie come too quickly. “Before I’ve had a chance to figure out what the actors are saying,” he writes, “a new scene begins.”

Zazetsky, a gifted student with three years of study in a polytechnical institute behind him, takes months to grasp a basic element of geometry, only to have that hard-won knowledge vanish hours later.

The bullet had damaged the part of Zazetsky’s brain that receives and processes input necessary for understanding the world. He could perceive properly with his eyes but could not deploy his brain to link perceptions or ideas, so he lived with disconnected elements. As Zazetsky put it in his diary, “I’m in a kind of fog all the time. . . . All that flashes through my mind are images, hazy visions that suddenly appear and disappear. . . . I simply can’t understand what these mean.”

He nevertheless writes a remarkable 3,000-page journal, gathered over the course of twenty-five painstaking years, in thick oilskin-covered notebooks. On some days, a sentence or two is all he can manage. “My memory’s a blank,” he writes. “I can’t think of a single word. . . . Whatever I do remember is scattered, broken down into disconnected bits and pieces.”

The damage to Zazetsky’s brain is widespread and by no means confined to the area of the wound itself. His memory for information, for example, is severely damaged. Gone are the names of his mother and sisters and his address. He is unable to follow what he hears on the radio and gets lost on walks in the town where he was raised. Six years of studying German and three of English, advanced classes in chemistry: all utterly gone.

He holds a needle and thread in his hands and has a vague idea of their workings, but he can no longer summon the names of these and many other things. He urgently needs a bedpan, but he cannot summon that word. What comes to him instead are the words duck and bird, and he cannot decipher which is which.

Zazetsky has a handsome open face, with a strong nose and rugged black eyebrows, and at first glance he seems unscathed. But looks deceive. He can neither see nor imagine the right side of his body. Although he regains the ability to write (after six months of intensive schooling), the process is tortuous and slow, and he can neither read nor remember what he writes. He can speak, but only with great difficulty.

Worst of all, perhaps, is that Zazetsky is fully aware of his neurological deficits and is powerless to do anything other than to write about them in his own painful yet eloquent way.

“This strange illness I have,” he writes, “is like living without a brain.”

Late May 1943, Moscow

Zazetsky comes under the care of Aleksandr Romanovich Luria, a forty-one-year-old psychologist and a physician not long out of medical school. Luria heads a research team at a Russian army hospital looking at ways to help brain-damaged soldiers compensate for their neurological dysfunctions. In his new doctor, Zazetsky has two bits of good fortune. First, Luria’s special and lifelong interest is aphasia—the difficulty speaking, reading, and writing that sometimes follows stroke or traumatic brain injury. Second, his brilliance is complemented by a rare compassion. Long after Zazetsky leaves the hospital, he and Luria remain close. They stay in touch for thirty years, meeting or speaking almost every week. A black-and-white photo of the two men shows them comfortably close together, each smiling at the other, Luria holding the fingers of Zazetsky’s left hand ever so delicately in his own.

The writing of Zazetsky (a pseudonym) finds its way into a book that Luria writes in 1972, The Man with a Shattered World: The History of a Brain Wound. Zazetsky wants to call his writing I’ll Fight On, and the title is a measure of the fierce resolve of this brain-damaged man to put the thoughts that come to him randomly into cohesive form. Zazetsky’s writing is a desperate search for meaning, undertaken in the hope that his probing will help both himself and others—scientists studying the brain and those in circumstances like his own.

Each man helps the other. Had Zazetsky not crossed paths with Luria and been encouraged by him (the latter called his patient’s writing “a triumph”), it’s almost certain he would never have written his astonishing journal.

Luria is fascinated all his life by the brain (today he is considered a pioneer in neurology and the father of neuropsychology), and Zazetsky furthers his knowledge. Luria writes, “Precise knowledge was rarely to be found in the textbooks, which were filled with vague suppositions and fantastic conjectures that made maps of the brain scarcely more reliable than medieval geographers’ maps of the world.”

“His [Zazetsky’s] description is exceptionally clear and detailed,” writes Luria, and “if we follow him step by step, we may unravel some of the mysteries of the human brain.” Through Zazetsky, Luria learned the geography and function of specific brain areas and made a major contribution to our understanding of the brain. The book you are now reading would never have been written had I not chanced across The Man with a Shattered World in 1977, the year Luria died. I shared Luria’s intellectual curiosity and Zazetsky’s reasoning deficit, as well as his determination. Zazetsky’s drive led him to labor all that time writing a journal as he strove to understand the “strange illness” that had suddenly and catastrophically befallen him, leaving him with a loss of meaning in his world. My own drive compelled me to search for a solution to the same neurological deficit that had robbed me of meaning since birth.

Our shared determination, I would later understand, was actually a shared strength in frontal lobe functioning, that part of the brain critical for planning and seeking solutions. A hallmark of good functioning in this region of the brain is driven determination in pursuit of a goal.

Peterborough, Ontario, 1957

Six years old, I hear an exchange that fills me with a quiet horror. I have accompanied my mother to an after-school parent-teacher meeting to discuss the teacher’s concerns about my slow progress.

“Barbara,” the teacher is explaining to my mother, “has a mental block.” As children do, I understood this truth quite literally. Evidently there was a chunk of wood lodged in my brain, and it would have to be removed.

The teacher was almost right. The word block missed the mark, but blockage was pretty close. For the first twenty-six years of my life, and I am fifty-nine years old as I write this, I lived in a dense fog not unlike Zazetsky’s.

I too could make no sense of the relationship between the big and little hands of an analogue clock. Asked to perform the simple addition of a two-digit column of numbers, I would randomly choose numbers from the left or right side. The logic of basic math, the concept of telling time, the ability to truly comprehend what I was hearing or reading: all eluded me. On the playground, I couldn’t follow conversations or the rules of simple games.

Depending on which question was asked on a test, I might get a grade of 29 or 92. What allowed me to progress through primary school, high school, university, and even graduate school were some exceptional strengths. My auditory and visual memory ranked in the 99th percentile (as a teenager I could watch the TV news at 6:00 P.M., and at 11:00 P.M., I’d parrot the broadcast as if I had the script in front of me). I also possessed exceptional mental initiative to attack and solve the problems that came my way, which translated into a singular work ethic and gritty determination to succeed.

My teachers’ opinions of me varied widely. I was labeled “gifted,” “slow,” and “difficult.” Some parts of my brain responded like a finely tuned musical instrument; others could not be relied on. There was no language then to describe my condition. The phrase learning disabled was coined only in 1962, by a Chicago psychologist named Samuel Kirk, and it did not come into common parlance until the late 1970s. Fifty years ago, when I was a child, students were seen as smart or slow or somewhere in between.

The educational system of the 1950s appeared to make up its mind about me early on. In the primary grades in those days, students were grouped with others who read at the same pace. I was put not with the “squirrels” (the quick readers), where I longed to be, and not the “rabbits” (the average readers) either, but with the “turtles” (the slow readers), who were mocked and teased by the other children. To my dismay, my reading problems were a result of letter and word reversals, which I could do nothing about. Almost universally assumed at the time was the idea that you had to play the hand you were dealt because the brain you were born with was fixed and hardwired. Period. A certain prevailing fatalism meant that I was told I had best learn to adjust.

My woes did not end there. As with Zazetsky, other areas of my brain were compromised. I took forever to learn how to tie my shoelaces, I was always getting lost, and I could not tell my left hand from my right. I constantly ran into things and bruised my body, chipped my teeth, and had stitches because my whole left side felt alien to me. I was “accident prone,” but there was a reason for that and my other woes, and it had everything to do with my brain.

Photographs of me at the time show a handsome child, long-haired and freckled, as you might expect of someone with my mixed Scottish, Irish, and English heritage (my forebears had come to North America in the early 1600s). But my smile then was always closemouthed, and there was something quite muted about me, tentative and shy.

Teachers and even my own friends and family had no real sense of the anguish my learning challenges caused me and how hard I had to work to maintain my grades. And as I advanced from grade to grade, the going got harder and I had to double and redouble my efforts.

Ahead would lie periods of despair. By my teens, suicide seemed to me the only option.

Toronto, Ontario, 1977

When I was twenty-five years old and in graduate school, I happened upon Luria’s The Man with a Shattered World and began reading Zazetsky’s account of his life. As I read his words—“I’m in a kind of fog all the time. . . . All that flashes through my mind are images, hazy visions that suddenly appear and disappear”—I was dumbstruck. This brain-damaged soldier was describing himself, but he was also describing me. I am Zazetsky, I thought. Zazetsky is me.

The giveaway was the story about the clocks. Trauma inflicted on a particular part of someone’s brain appeared to result in that person losing the ability to tell time. If Zazetsky was the man who couldn’t tell time in postwar Russia, I was his female counterpart in Canada a few decades on. But where a bullet had inflicted the damage on this soldier’s brain, I entered the world with my brain already damaged. Our problems had dramatically different origins, but their outcome was precisely the same.

I finally had an explanation for what had ailed me all my life. Here was evidence that my particular learning disabilities were physical, with each one rooted in a specific part of my brain. This realization marked the turning point in my life.

By reading Luria’s books, The Man with a Shattered World and Basic Problems of Neurolinguistics, I came to understand that for both Zazetsky and me, the primary problem lay in the left hemisphere at the intersection of three brain regions: the temporal (linked to sound and spoken language), the occipital (linked to sight), and the parietal (linked to kinesthetic sensations). This is the part of the brain necessary for connecting and relating information coming in both from the outside world and from other parts of the brain in order to process and understand it. Both Zazetsky and I saw perfectly well and heard perfectly well; making sense of what we saw and heard was the issue.

As long as I live, I will never forget the palpable excitement I felt as I read Luria for the first time. Every page of his books offered revelations that I underlined and reread.

“The bullet that penetrated this patient’s brain,” Luria wrote, “disrupted the functions of precisely those parts of the cortex that control the analysis, synthesis, and organization of complex associations into a coherent framework.”

Zazetsky and I could not make meaningful connections between symbolic elements, such as ideas, mathematical concepts, or even simple words. As he put it, “I knew what the words ‘mother’ and ‘daughter’ meant but not the expression ‘mother’s daughter.’ The expressions ‘mother’s daughter’ and ‘daughter’s mother’ sounded just the same to me.” I too, could not grasp the difference between “father’s brother” and “brother’s father” even when such language could be mapped onto concrete experience (my father did indeed have a brother).

Both Zazetsky and I caught fragments of conversations, but we never grasped the whole. The words came too quickly for us to decipher their meaning. My habit had been to replay—as many as several dozen times—simple conversations, the lyrics of a song, the dialogue in a movie as I strove to understand. But how could I understand even one sentence? I was still working on the meaning of the first part of the sentence and missed what came after. Logic, cause and effect, and grammar befuddled me, just as they had Zazetsky.

During this time, I came across the research that an American psychologist, Mark Rosenzweig, at the University of California at Berkeley had conducted with rats. He demonstrated that the brain can physically change in response to stimulation. If a rat can change his brain, I thought, perhaps a human can do the same. I married the work of Rosenzweig and Luria in order to create an exercise to change my brain.

The exercise, I knew, would have to be central to the function of my brain’s particular weak spot. If my brain, for example, had trouble interpreting relationships, would rigorous practice interpreting relationships over a sustained period of time address the problem?

I had no idea whether this might work, but I had nothing to lose but time. And this I had already lost. Luria explained that people with lesions in this cortical region (the juncture in the brain of the parietal-occipital-temporal lobes) had difficulty telling time on an analogue clock. I wondered if a clock-reading exercise might stimulate this part of my brain.

I created flash cards, not so different from the ones my mother had used with me in first grade to teach me number facts. But this wasn’t rote. This was me in 1978 at the age of twenty-six trying to activate a part of my brain that had never worked properly. Since I could not accurately tell time, I had to use a watch and turn the hands to the correct time (with a friend’s help), and then draw the clock face. I would do the exercise every day for up to twelve hours a day, and as I got better at the task, I made the flash cards more complex, adding more, and more challenging, measures of time. They were relational components.

I threw myself into the exercise, as is my style. My brother Donald used to call me “an engine without a regulator.”

The name of the game was speed and accuracy. How quickly could I calculate time—first simple time, then complex time? By gradually speeding up the exercise and making it harder, could I go from not being able to tell time to being better at it than the average person? If this worked—if I could get faster and more accurate at processing relationships on the clocks—then I had some hope that the related symptoms clustered in this impaired part of my brain might likewise improve: my inability to comprehend written material, my woeful grasp of math, my general lack of understanding in real time.

I cannot describe my exhilaration when I began to feel the result of all this work. Points of logic became clear to me, and elements of grammar now made sense, as did math. Conversations that I had always had to replay in order to comprehend now unfolded for me in real time. The fog dissipated and then lifted. It was gone for good.

What had happened? The part of my brain that was supposed to make sense of the relationship between symbols—most famously in my case, the hands of a clock—had been barely functioning. The work I did with flash cards activated that moribund part of my brain, getting the neurons to fire in order to forge new neural pathways. This part of my brain had been asleep for the first twenty-six years of my life, and the clock exercise had woken it up.

And what about my other issues: my klutziness, my penchant for getting lost? Did these problems have their origins in my brain, and could they too be helped or even eliminated by stimulating different parts of my brain? But which parts? And what exercises? This became my quest: to use what I’d learned from this experiment to wake up other areas of my brain.

What I have learned by doing this work for some thirty-four years is this: just as our brains shape us, we can shape our brains.

CHAPTER ONE

THE ANATOMY OF RESISTANCE

Why are educators still telling parents that learning disabilities are lifelong? Given the great weight of evidence for neuroplasticity, why are cognitive exercises not more widely recognized as a treatment for learning disabilities?

We now take it as a given that the brain is inherently plastic, capable of change and constantly changing. The human brain can remap itself, grow new neural connections, and even grow new neurons over the course of a lifetime.

When I went to university in the 1970s, I was taught that the brain was fixed: what you were born with is what you lived with all your life. This belief that a learning problem is a lifelong disability had major implications for education and learning. Education was about pouring content into a fixed system—the brain. At one point, it was argued that there were critical periods in childhood when the brain could more efficiently learn; once this window closed, such learning became more difficult. At best, then, the brain was seen as a fixed system with brief periods of malleability.

I remember attending a lecture in the late 1980s and being told that children with learning disabilities could be likened to different animals with various strengths. The eagle could soar and see the world from on high, the squirrel could run fast and climb trees, and the duck could gracefully swim in the lake. We were then admonished: never make the duck try to climb or the eagle to swim or the squirrel to fly. Find each child’s unique gifts, we were told, and work on developing them because children could deploy them to compensate for things they could not do.

My own education had been grounded in this approach. And I knew from my own experience that the enormous expenditure of energy made in attempting to work around problems generated limited results.

Norman Doidge, the author of The Brain That Changes Itself, argues that centuries of viewing the brain as a machine, rather than an organ capable of regenerating itself, gave rise to what he calls neurological fatalism: the belief that to be born with a learning disorder was to live with it until death.

Presuppositions in any field (mine happens to be school psychology) determine how we carry out our investigations and what we believe is possible. Those presuppositions shape our view of reality and can become entrenched as truth, rarely to be questioned.

This, too, is neuroplasticity at work: we all create a map of how the brain works—a map based on our knowledge and training. Many people have not yet formed or understood the new map of the neuroplastic brain, especially in relation to education.

Doidge describes what he calls “the plastic paradox.” The property of plasticity can give rise to both flexible and rigid behaviors. Because trained neurons fire faster and clearer signals than untrained neurons, when we learn something and repeat it, we form circuits that tend to outcompete other circuits. Soon there is a tendency to follow the path most traveled. If your occupation is offering remedial programs, this means: “We’ve always done it this way; let’s continue doing it this way.” Once a way of thinking and practicing within a framework becomes habitual, it becomes ingrained, and a significant amount of energy is required to reshape old thought patterns and institute new practices.

Although we now know that age, training, and experience make for a constantly changing brain, many educators have yet to learn how to deploy the principles underlying neuroplasticity (that is, to treat learning disabilities). Even educators who recognize that the brain is changeable are still engaged in professional practices based on the old brain-is-fixed paradigm. Certainly it takes time, effort, and learning to integrate new knowledge into common practice; meanwhile, most treatments for children with learning disabilities remain based on those old notions of hardwired brains and lifelong disabilities.

Thomas Kuhn, in his classic work published fifty years ago, The Structure of Scientific Revolutions, explains how the process of discovery works in science and what happens when there is a paradigm shift. Every field of science has foundational beliefs that people within that field learn as part of what Kuhn calls “educational initiation that prepares and licenses the student for professional practice.” These beliefs and assumptions determine what is to be studied and researched within that scientific discipline. Research within the paradigm is designed to gather knowledge within the framework of the paradigm. In the process of research, as Kuhn describes it, anomalies emerge that cannot be explained by the paradigm’s assumptions. At first, these anomalies are ignored or resisted. Over time, it’s recognized that they violate the paradigm and need to be investigated. Finally, the old paradigm begins to shift, and the one that emerges encompasses the anomalies. Kuhn argued that a paradigm change is in essence a scientific revolution, and that the new scientific theory demands rejection of the older one. In this way, science develops. Neuroplasticity is one such new paradigm.

What we urgently need now is a new paradigm in education—one that crosses the great divide between neuroscience and education. This new model will wholeheartedly embrace the life-altering concept of the changeable brain and use the principles of neuroplasticity. The end result will be a fundamental change in the learner’s capacity to learn.

Harvard University has developed the Mind, Brain, and Education Institute, devoted to bridging the gap between neuroscience and education. Its goal is to connect the disciplines; bring together educators and researchers to explore the latest research in cognitive science, neuroscience, and education; and apply this knowledge to educational practice. To help advance this goal, the institute also publishes a journal, Mind, Brain, and Education.

In an article published in fall 2010, “Linking Mind, Brain and Education to Clinical Practice: A Proposal for Transdisciplinary Collaboration,” authors Katie Ronstadt and Paul Yellin note: “Increasingly, neuroscientists are identifying the neural processes associated with brain development, the acquisition of academic skills, and disorders of learning. Integrating this emerging knowledge into education has been difficult because it requires collaboration across disciplines.” Part of the challenge, they note, is that neuroscientists and educators have different languages, frameworks, and priorities.

I started Arrowsmith School in Toronto in 1980. It evolved from my experience using the principles of neuroplasticity to address my own learning problems. I had become increasingly aware that traditional methods of dealing with learning-disabled students had only limited success. The Arrowsmith Program was developed from research in neuroscience, not education. The fundamental premise of my work is that by changing the brain, the learner’s capacity to learn can be modified.

The principle of neuroplasticity is considered part of the field of neuroscience and has not traditionally been taught in teachers’ colleges or studied widely in the educational system. Teachers who become administrators are taught that their job is to teach content. Thinking about rewiring the brain (so that the student becomes more capable of learning content) marks a radical departure from their traditional job description.

When I started this work more than thirty years ago, neuroplasticity was being discussed and researched in laboratories, but it was neither widely known nor well accepted. Only since 1990, partly encouraged by President George H.W. Bush’s proclaiming the 1990s the Decade of the Brain, has neuroplasticity been investigated extensively. I vividly remember standing on Yonge Street in Toronto outside my school in May 1999 as I excitedly told a colleague about an article I had just read: “New Nerve Cells for the Adult Brain,” by Gerd Kempermann and Fred H. Gage in Scientific American. This marked the first time I became aware of not just neuroplasticity but neurogenesis—how the adult brain can actually grow new neurons in the hippocampus, an area of the brain important for memory and learning. The brain was more plastic, more malleable, than originally thought.

Only as recently as 2000 did Eric Kandel of Columbia University win the Nobel Prize for his work demonstrating that learning in response to environmental demands changes the brain. Here was more proof of neuroplasticity. After Kandel won the Nobel Prize, it took several more years for the concept to reach the mainstream through media attention. Only in the past few years has the idea become broadly accepted in theory. In terms of the history of science and the acceptance of ideas, this is a fleeting moment.

Santiago Ramón y Cajal (1852–1934), considered one of the great pioneers in neuroscience, theorized the concept of neuroplasticity long before we had the refined technology and techniques to demonstrate it. He hypothesized, but could not prove, that the brain can be remapped, its very structure and organization changed, by the right stimulation. “Consider the possibility,” he once said, “that any man could, if he were so inclined, be the sculptor of his own brain, and that even the least gifted may, like the poorest land that has been well cultivated and fertilized, produce an abundant harvest.” This Spanish neuroscientist and histologist (one who studies the microscopic structure of tissue) won the Nobel Prize in 1906. Almost a century later, Kandel’s work confirmed Cajal’s hypothesis that the brain is plastic and changes occur at the synaptic connections between neurons.

The terms neuroplasticity and brain plasticity might feel new, but that’s because it is only recently that these terms have gained currency. In fact, these terms have been around a long time, and research in neuroplasticity—though mostly on the margins, it must be said—has been under way for more than two hundred years.

In 1783, an Italian anatomist named Michele Vincenzo Malacarne studied the impact of exercise on the brain. He took pairs of birds from the same nest and subjected one pair to intense training, the other pair to none. He then conducted the same experiments with dogs: one pair got the enrichment of intense training, and the other pair got no stimulation. When the animals were euthanized, Malacarne found that the brains of stimulated animals were larger than those of their counterparts, and especially in the cerebellum—the part of the brain that governs motor control and coordination. And 165 years later, Jerzy Konorski, a Polish neurophysiologist, used the terms brain plasticity and neural plasticity in a book he wrote in 1948: Conditioned Reflexes and Neuron Organization.

Today neuroplasticity is generating a lot of excitement in areas of rehabilitative medicine, where good news is rare. Norman Doidge chronicles in one of his documentaries some of the promising research being conducted. Jeffrey Schwartz, an associate professor at the UCLA School of Medicine in California, for example, is using what he calls “self-directed neuroplasticity” in treating obsessive-compulsive disorder (OCD). The classic example of OCD is the person who can neither stop thinking about germs nor stop washing his hands to kill germs. Schwartz is deploying the principles of neuroplasticity to forge new pathways in his patients’ brains. His patients are learning firsthand that the brain can change its structure in such a way that the impulses can be recognized as just that—mere impulses. The physiological changes that accompany this mental shift are visible on their brain scans.

Alain Brunet, an associate professor in the Department of Psychiatry at McGill University in Montreal, is using the malleability of the human brain to treat people suffering from posttraumatic stress disorder. These are victims, for example, of rape, child abuse, car accidents, and hostage takings for whom the event remains very much alive in their minds. Brunet is reporting success using a blend of pharmacology and neuroplasticity. These patients are first given medication to dampen the emotion associated with these memories and then asked to repeatedly recall the event. These men and women are rewiring their brains, disconnecting the circuitry linking the memory of the event to the arousal of their own threat systems. This process allows each person to file the memory in a new folder in the brain, not in the virtual present but in its rightful place—in the actual past. This is the principle of neuroplasticity in action: neurons that fire apart, wire apart. These new treatments for trauma usefully exploit this fact: when you remember a traumatic event, the network for that memory enters a more malleable state, and the treatment proceeds in that heightened neuroplastic milieu.

Finally, researchers in California are using cognitive exercises to help those with schizophrenia address some of the cognitive problems associated with their condition. Such people have difficulty perceiving, processing, and remembering information, and neuroscientists Sophia Vinogradov and Michael Merzenich are using specially designed computer programs to improve these cognitive functions. Brain imaging, their research shows, has demonstrated that these cognitive exercises change regions of the prefrontal cortex—those involved in regulating attention and problem solving—of a person with schizophrenia so it begins to look more like a normal brain.

In addition, a protein in the brain called BDNF (brain-derived neuro-tropic factor, also known as the “brain’s fertilizer”) is typically low in the brains of those with schizophrenia. Critical for neuronal survival, BDNF is also believed to play a vital role in what neurologists call activity-dependent plasticity (a term used to describe the brain’s ability to change as the result of specific sustained stimulation). These exercises increase BDNF levels to normal—further evidence of neuroplastic change.

“We know the brain is like a muscle,” says Vinogradov. “If you train it in the right way, you can increase its capacity. The brain is ever changing in relation to what’s happening to it. With the correct training, we can improve cognitive processes that weren’t strong to begin with by improving the processing pathways.” Says her colleague, Dr. Merzenich, “The brain changes—physically, chemically, functionally.”

“It’s unrealistic,” Norman Doidge told me recently, “to expect that the definitive demonstrations of neuroplasticity in the laboratory will suddenly undo the doctrine of the unchanging brain that so many were taught. Intellectual revolutions require time to spread. In the meantime, those few who have understood that neuroplasticity has immediate applications face incredulity or even opposition. That is what happens when you are at the cutting edge. It’s lonely out there. But a lot of the opposition to the idea will pass generationally because in the last few years, all the major neuroscience texts have chapters on neuroplasticity. I’m not worried about its clinical acceptance in the long term.”