How Not to Train the Brain
May 24, 2010
A study called “Brain Test Britain” is receiving a lot of attention because of its findings that discount the effectiveness of cognitive training. Close inspection of this study reveals many gaps in its methodology and what they consider “brain training.”
They had no screening for suitable candidates with a specific problem, no focus on a specific cognitive function, no proven exercises based in neuroscience (only a series of games), and a haphazard, low-effort training protocol. Finally, there was no coaching provided to the users – of course leading to very poor compliance.
If the British study had managed to create any useful improvement in the test subjects with this kind of “fun and games brain training,” it would have been remarkable. This study is actually a good example of how not to train the brain. It takes specific, intensive, and sustained training to change cognitive performance.
News on Neuroplasticity
May 23, 2010
The Brain That Can
After reading the book The Brain that Changes Itself, by Norman Doidge (2007) I have been convinced that my longstanding views on the capacity of the brain to change are frankly, wrong.
I have worked in brain injury rehabilitation for a good portion of my career in neuropsychology which included stroke, brain injury and aneurysm patients. Patient would typically spend 1 – 2 months in inpatient rehabilitation receiving cognitive remediation and physical therapies daily, then transfer to outpatient therapies for treatment several days a week for several more months. We would typically see a plateau in functioning for stroke patients after 4 – 5 months, and between 1 – 2 years in brain injury patients, depending on the severity of the injury.
New research has clearly indicated that localization theories were misguided. Areas of the brain, previously felt to be ‘designated’ to perform sensory functions (vision, hearing, motor functioning, touch) or language areas, are remarkable plastic and eager to take on new functions if the information is provided to them under certain guidelines. He describes patients years after stroke, who can begin to restore motor, sensory or cognitive functioning, under the right conditions.
What are these conditions? “Neurons that fire together, wire together”. In other words, information presented repetitively, and frequently, over a lengthy duration, will create new circuitry. So a stroke patient, using his paralysed hand in various tasks, for an hour a day, 5 days a week, for several months, in most cases improves the functioning of that hand. The length and repetitiveness of the task, eventually causes new neuronal sprouting (which in the case of learning Braille only begins to occur after 4 months) causing permanent changes in the brain. With the limited therapy provided in rehabilitation settings, no wonder no one saw continued progress and improvement; the duration and frequency were not enough to create the new circuitry.
How does this apply to ADHD? Therapies, such as CogMed, meet such criteria due to the frequency, duration and a third factor which is also critical, the engagement or motivation factor. One has to be attentive and actively engaged in the task for these circuits to occur, and the engaging, self-competitive nature of a therapy, such as CogMed, can provide the motivation, to improve working memory systems and enrich and enhance the circuitry.
I have always been on the pessimistic side, when it comes to thinking people can change personality traits, or noxious habits. After reading his clearly presented summation of research, however, I am much less pessimistic. If one is truly motivated to change an identified trait, therapies can most certainly help if, there is daily work addressing the positive trait to be acquired, (e.g., through journaling, prayer, meditation, a diary, counseling meeting), and patience. Eventually, the unwanted traits (circuits) weaken, and the positive traits (circuits) strengthen, leading to good riddance. His successful work with obsessive-compulsive clients are a testament to this.
A New Way to Help Change Your Behavior
May 1, 2010
David told me he needed help getting things done on time, but when I started talking with him about how he managed the details of his life, he stopped talking about changing and started talking about how he had always been late and would never change.
“I always say I will get a project done early, but I never have. I always just end up feeling like such a loser and then I do it again the same way next time. I can’t change.”
Ron came into our first meeting and said his wife was about to leave him because he was never on time.
“I promise to be home before the kids are in bed, but then I just get caught in a project at work and it’s 9:00 PM before I get home. I’ve tried everything, but I’m just not going to change.”
Sheila and Ted were referred by Ted’s doctor for couple’s coaching. When I asked, “What would your life look like if it suddenly improved?” Sheila’s frustration just burst forth.
“He keeps telling me that he’ll do better, but it’s been fifteen years and he still never gets anywhere on time. Am I supposed to act like that’s normal?”
Ted looked up sheepishly and reported, “I feel terrible and I know I’m impossible to live with, but no matter what I try it doesn’t work. I’m just a mess; what can I do?”
Each of these clients ended up making changes that made life easier for them and for their spouses and work colleagues. And where did I suggest they start? By forgiving themselves.
A study by M. Wohl et al, detailed in a paper entitled, “I Forgive Myself, Now I Can Study: How Forgiveness for Procrastinating Can Reduce Future Procrastinating,” gives some interesting evidence that forgiving yourself for messing up can help free you to give a better effort at trying again.
In my practice I’ve seen that an increased ability to implement a new approach, along with an effective technique and the support of an understanding ally can make a huge difference. I encourage my clients to pay close attention to the fact we’re talking about forgiving themselves. And while it may be helpful for their spouse to forgive them, it’s the self-forgiveness and then a sincere new effort that is key.
Did you know that old dogs can learn new tricks? And people of all ages can and do learn new ways to act in their lives, especially if they can forgive themselves for past mistakes.
Give a call if I can help, 978-446-9600.
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