Neuroplasticity is a concept that should have huge implications for victims of combat stress because it suggests that the events that change someone's brain can be changed again. Although something cannot be undone, perhaps there are ways to alleviate dramatic changes.
To me, that suggests there can be hope for victims of post-traumatic stress disorder (PTSD).
In his remarkable book, The Brain That Changes Itself, Dr. Norman Doidge mounts a compelling argument that the brain is plastic. By that, he means that the brain adapts to the events that it encounters; in effect, it shifts its resources to meet changing conditions.
That's something most of us have encountered. For example, we may have known or heard about a blind person whose sense of hearing is remarkably keen. But Doidge takes that concept a step further. He writes about implanting electrodes into a monkey's brain and watching different electrodes fire up as the monkey's fingers explore an abject. Then all the fingers are taped together. After a few days of confusion, a new pattern emerges from among the electrodes as the monkey's brain recognizes that all the fingers are now acting as a single unit.
Doidge also writes about a woman whose vestibular system had been destroyed by an infection some years before, leaving her with virtually no sense of balance. She could not stand upright because she kept falling down. Then one of the pioneers of neuroplasticity, Paul Bach-y-Rita, devised a special construction-style hat that took the spatial measurements from her optical nerves and relayed them to a device in her mouth that transmitted them to her tongue. It not only allowed her to learn to stand erect again, but it also showed her brain how to rewire itself to allow the woman to keep her balance without the mechanical hat.
The concept of a brain evolving destroyed the earlier theory that the brain is a machine, a sort of super-computer that couldn't really change or grow.
"The idea that the brain can change its own structure and function through thought and activity is, I believe, the most important alteration in our view of the brain since we first sketched out its basic anatomy and the workings of its basic component, the neuron," Doidge writes in the preface of his book. "The neuroplastic revolution has implications for, among other things, our understanding of how love, sex, grief, relationships, learning, addictions, culture, technology, and psychotherapies change our brains. All of the humanities, social sciences, and physical sciences, insofar as they deal with human nature, are affected, as are all forms of training. All of these disciplines will have to come to terms with the fact of the self-changing brain and with the realization that the architecture of the brain differs from one person to the next and that it changes in the course of our individual lives."
Just think of the implications for combat vets!
PTSD is all about a brain being changed during combat. It's about that heightened awareness that comes to a soldier who knows he's in danger. His frontal cortex is analyzing all the signals from his eyes and ears, trying to sense the threat. That information is instantly passed along to the amygdala and the hippocampus, which are gearing the body up for a fight or a flight. The heart is pounding, the adrenaline is flowing, and the nerves are so tight they feel like they could snap under the strain. This is a normal response to danger. And when the threat subsides, it's normal for the body to return to "normal."
But when you get wave after wave of danger, the brain stays on high alert ... and that becomes "normal." But when the danger disappears and the brain remains on high alert, that's what we call PTSD.
So far, our ways of treating PTSD haven't been very effective. Drugs such as psychotropic medications can dull the pain, but leave patients numb. Talk therapy can let a vet know he's not alone with his emotional wounds and can help him understand that what he's going through is a natural response to combat, but that probably won't alleviate the nightmares or the flashbacks or the instinctive response to hit the deck when a car backfires.
Now Doidge, who is on the faculty of the University of Toronto's Department of Psychiatry and Columbia University's Center for Psychoanalytic Training and Research, is telling us that we should be able to change a brain back again. Obviously, we can't erase an event, particularly such a compelling one as combat, from our memories. But we might be able to weaken the combat images by changing the way the brain processes them.
More on that in my next blog.