Changing our minds about changing the brain.

When I first learned of 'neuroplasticity' I was very excited by the idea that we might be able to understand the brain well enough to change it in precise and purposeful ways.

That was about ten years ago (In 2002-3 I completed a masters degree in Mind, Brain and Education at Harvard University) when I felt that the key to solving the world's problems was to know the brain better, which would ('somehow') lead to incisive educational methods, integrated humans and happy, functional societies.

It was 'a false dawn'. I gradually realised that we didn't know enough about the brain, nor enough about the myriad of complex connections between brains and minds and learning and society. Moreover, at some point it struck me forcibly that even if we knew everything there was to know in this respect, there would always be a huge value judgement involved in making sense of the implications. (A recent report I wrote for the RSA makes this case in detail).

My belief in the promise of neuroscience, as is the case for many I think, was grounded in a kind of ontological insecurity - the felt sense of lack, a need for firm foundations to make sense of who and what we are and, consequently, how we should live our lives. Alas, while Neuroscience may, in time, give a clearer sense of bio-chemical foundations, that will not, in turn, give us foundations for difficult social and ethical decisions that rely on judgements of value.

Alas, while Neuroscience may, in time, give a clearer sense of bio-chemical foundations, that will not, in turn, give us foundations for difficult social and ethical decisions that rely on judgements of value.

However, while it is important to keep such qualifications in mind, and not to get too carried away with the latest brain-related findings, I also think it is a huge mistake to think that neuroscience has nothing to offer in practice. For instance, I came across a very powerful example in the Guardian that made me think again about the importance of neuroplasticity.

Barbara Arrowsmith Young was a very bright child but with very distinct cognitive limitations. She struggled to make sense of the meaning of things like analogue clock times, even though she could, for instance, recite a recent news broadcast verbatim. By taking an active interest in exactly what she could and couldn't do, she developed a sophisticated set of cognitive exercises to gradually develop parts of her brain that were not previously functioning the way they should.

In the Guardian article her training is described as follows:

"So she started devising brain stimulation exercises for herself that would work the parts of her brain that weren't functioning. She drew 100 two-handed clockfaces on cards, each one telling a different time, and wrote the time each told on the back of the card. Then she started trying to tell the time from each, checking on the back each time to see if she was right. She did this eight to 10 hours a day. Gradually, she got faster and more accurate. Then she added a third hand, to make the task more difficult. Then a fourth, for tenths of a second, and a fifth, for days of the week."

Barbara herself describes her breakthrough as follows:

As Arrowsmith Young herself puts it: "It's because they're not actually any of those things," she says. "They don't really have ADHD or dyslexia. They just have a couple of cognitive pieces that aren't functioning as they should. It's about going beneath the label."

"I was experiencing a mental exhaustion like I had never known," she says, "so I figured something was happening. And by the time I'd done that for three or four months, it really felt like something had shifted, something had fundamentally changed in my brain, allowing me to process and understand information. I watched an edition of 60 Minutes, with a friend, and I got it. I read a page of Kierkegaard – because philosophy is obviously very conceptual, so had been impossible for me – and I understood it. I read pages from 10 books, and every single one I understood. I was like, hallelujah! It was like stepping from darkness into light."

I would encourage readers to look at her example and the teaching methods that fell out of it in more detail. I haven't looked closely at the evidence base, and it is worth asking how much of this is about the brain, and how much of it is about cognition(and how much does that question matter?!). Still, the narrative power of her example certainly made me think again about neuroplasticity. I had always felt people got a bit too excited about it (I mean of course we can change our brains- they change all the time!..) but the idea that specific cognitive interventions can made lasting neural impact on areas that require it, which in turn improves one's quality of life is worth pondering.

According to the Guardian article, thousands of children diagnosed with ADD or ADHD, dyslexia or dysgraphia, dismissed as impossible to teach, have attended Arrowsmith schools for three or four years, returned to a mainstream school, and gone on academic and professional success.

As Arrowsmith Young herself puts it: "It's because they're not actually any of those things," she says. "They don't really have ADHD or dyslexia. They just have a couple of cognitive pieces that aren't functioning as they should. It's about going beneath the label."

One question that follows is what 'going beneath the label' means in practice. Does it mean brain scans, or just cognitive testing, or both? Is this really a case where it is the neuroanatomy and neurochemistry of the brain as such that matters, or is it another example where we use brain-based language, particularly 'neuroplasticity' (which sounds rather like a desirable toy) to glamorise a case that does not rely on a deeper understanding of the brain at all.

On the other hand, if this glamorising is necessary to get the attention and funds needed to improve people's lives, perhaps we should actively encourage it?