Chapter six, Brain Lock Unlocked, Using Plasticity to Stop Worries, Obsessions, Compulsions, and Bad Habits from the text “The Brain That Changes Itself” is the topic of choice for this paper. Neuroplasticity is an intriguing subject and so is the idea of using it as a treatment for neurological disorders through talk therapy. This talk therapy is able to rearrange the brain and improve a disorder. Neuroplasticity is the ability of the nervous system to respond to intrinsic and extrinsic stimuli by reorganizing its structure, function, and connections. It occurs during early development can occur later in life in response to the environment. Chapter six focuses on plasticity-based therapy for obsessive-compulsive disorder (OCD); however, this therapy can be used and has been used for many more disorders that don’t already have a successful treatment in place. The two articles chosen review the effectiveness of neuroplasticity as a therapy option for patients with Schizophrenia and brain damage.
Brain Lock Unlocked
Obsessive-compulsive disorder (OCD) is among the worst of anxiety disorders. Medications alleviate symptoms, but do not eliminate them. OCD often worsens over time, gradually altering the structure of the brain. A patient with OCD may try to get relief by giving in to his compulsion, but the more he focuses on it, the worse it gets (Doidge, 2007, p. 117).
Typical obsessions consist of fears like being contaminated by germs or chemicals, or being obsessed with symmetry. The concerns don’t usually make sense and the patient understands this, but they still can’t help the feeling and must act on it. When a person tries to resist a compulsion it consumes them, but if they act on it to get temporary relief, this only encourages negative behavior and enhances the disorder.
OCD has been very difficult to treat. Medication and behavior therapy are only partially helpful for many people (Doidge, 2007, p. 119). The most common treatment for OCD is called 'exposure and response prevention,' a form of behavior therapy that helps about half of OCD patients make some improvement, though most don't get completely better. Another form of therapy, Cognitive Therapy, is based on the premise that problematic mood and anxiety states are caused by cognitive distortions, inaccurate or exaggerated thoughts (Doidge, 2007, p. 122).
Jeffrey M. Schwartz developed an effective talking therapy that could change the brain. Through plasticity-based treatment, a patient’s brain is able to normalize. The caudate nucleus, our brain’s 'automatic gearshift”, sits deep in the center of the brain and allows our thoughts to flow from one to the next unless, as happens in OCD, the caudate becomes extremely 'sticky' and the caudate doesn't 'shift the gear' automatically, and thoughts get stuck. Schwartz wondered whether patients could shift the caudate 'manually' by paying constant, effortful attention and actively focusing on something else pleasurable. This approach makes plastic sense because it 'grows' a new brain circuit that gives pleasure and triggers dopamine release which, as we have seen, rewards the new activity and consolidates and grows new neuronal connections. This new circuit can eventually compete and weaken the older one. This treatment will basically replace bad behaviors with better ones (Doidge, 2007, pp. 120-121).
Once a patient has acknowledged that the worry is a symptom of OCD, the next crucial step is to refocus on a positive, pleasurable activity and “shift” the gear manually the moment he becomes aware he is having an OCD attack. This will assist in growing new circuits and altering the caudate. 'The struggle is not to make the feeling go away; the struggle is not to give in to the feeling'. The goal is to resist the OCD sympton by 'changing the channel' to a new activity for as long as possible. Any time spent resisting is beneficial and that effort is what appears to create new circuits. Schwartz has had good results with by using his method in combination with antidepressants. The medication functions like training wheels on a bike, by lowering the anxiety enough for patients to benefit from the therapy and some patients don't even need it to start with (Doidge, 2007, p. 123).
A Case Study on Promoting Neuroplasticity in a Patient with Schizophrenia
Current studies indicate that neuroplasticity-based cognitive training in schizophrenia has shown improvement in verbal learning/memory and cognitive control. This article focuses on the case study of a male diagnosed with Schizophrenia. The strategies used included cognitive remediation, physical exercise, and sleep. Cognitive remediation focuses on problems of memory, executive function, language, and attention and functional outcome. Such benefits result in improved behaviors, problem-solving, reduced symptoms and occupational outcome, therefore better recovery for people with schizophrenia. Physical activity improves learning and memory function in the hippocampus, releases neurotrophins that facilitate neuronal growth, and uses synaptic plasticity to promote brain health (Puskar, Slivka, Lee, Martin, & Witt, 2015, pp. 2-3).
The subject in this study used three coping techniques to manage his symptoms; deep breathing, basic T’ai Chi movements, and wearing headphones. T’ai Chi concentrates on relieving the physical effects of stress on the body and mind. The subject reported he never experienced hallucinations during T’ai Chi class. The use of headphones was to override hallucinations and act as a distraction until they lessened or were ignored. The coping strategies seemed to help the subject “shift gears” manually. This treatment lasted for 1 year with continuous improvement. These three approaches highlighted the unique role of neuroplasticity. Just like Schwartz’s therapy, the disease was explained to the patient in order for him to understand it and gain control of it. Understanding the brain and neuroplasticity enables alteration of neurocognitive functioning and adds to the patients toolkit of knowledge and behavioral skills to cope with the disease of schizophrenia (Puskar et al., 2015, pp. 4-5).
Harnessing Neuroplasticity: Modern Approaches and Clinical Future
This article reviews modern approaches of inducing neuroplasticity in patients or models of neurological disorders whereby neuroplasticity is known to be impaired, from neurodegeneration to traumatic brain injury and learning disability (Octavian Sasmita, Kuruvilla, & Pick Kiong Ling, 2018, p. 3). The nervous system could adapt and reorganize in cases of epileptic seizures, stroke and traumatic brain injuries; however, the degree of restoration varies. In addition to being effective, it is a marketable therapy due to it being low-cost, non-invasive, low-tech and non-drug (Octavian Sasmita et al., 2018, p. 8).
Induction of neuroplasticity has been a longstanding concept in neurorestoration. From molecular approaches to activity-dependent neuroplasticity. It has great potential in battling various neurological and neurodegenerative diseases. However, there needs to be careful consideration upon viewing neuroplasticity research as some are only symptom-curative. Neuroplasticity can possibly gain commercial success, but higher technology and more collaborative efforts are recommended (Octavian Sasmita et al., 2018, p. 10).
Neuroplasticity has been proven to be an effective treatment with some disorders, more research is needed to expand the benefits of neuroplasticity throughout various neurological disorders. However, previous studies do show positive effects and promise with this type of therapy. While searching for information on this topic I came across several therapeutic services/providers using this technique. This is just a few: The Center for Brain (offers therapy for ADHD, anxiety, learning disabilities, bipolar disorder, OCD, brain injury, etc.), The OCD Treatment Centre (offers therapy for OCD), Apex Brain Centers (offers therapy for addictions, brain injury, etc.). There were also several articles in support of this technique. This is a very interesting field and I look forward to learning more about it.
References
Doidge, M. (2007). The Brain That Changes Itself. Penguin Group.
Puskar, K., Slivka, C., Lee, H., Martin, C., & Witt, M. (2015). A Case Study on Promoting Neuroplasticity in a Patient with Schizophrenia. Perspectives in Psychiatric Care, 52, 95–101
Octavian Sasmita, A., Kuruvilla, J. & Pick Kiong Ling, A. (2018). Harnessing neuroplasticity: modern approaches and clinical future. International Journal of Neuroscience, VOL. 128, NO. 11, 1061–1077