Making New Pathways

  Making New Pathways
  by
     Michael Noel - SQHP
  (First published in the 2009 Autumn edition of Fidelity - The Journal for the National Council of Psychotherapists)

In all my long years in complementary medicine I had always given more credence than many of my peers at the time to the idea that ‘thinking it started the ball rolling’.

In the Bible, John says that ‘in the beginning was the Word’. I always felt that should have been ‘in the beginning was the Thought’. It is the intention that starts things happening.

This has come more to the fore since I’ve been working with stroke and brain injury survivors because I have been required to research so much of the scientific evidence regarding the brain’s ability to ‘change itself’, otherwise known as neuroplasticity.

In order to play five notes on the piano steadily and smoothly a new student must repeatedly practice the finger movements over and over again. By doing this, they are in effect forming new neural pathways in their brain thereby enabling them to learn the muscular coordination required to obtain the desired effect. But, it is the intention, the original thought that ‘I am going to do this’ which starts the whole thing going. Without that, there would be no result.

So I developed a programme for my brain/stroke injury clients (through the local branch of the Headway charity) whereby they would, under hypnosis, visualise practicing a limb movement or vocal sound and then, once out of hypnosis, practice the same thing again, but in real time. I didn’t know how this was going to work out, but I felt that the theory was correct, even though I had no way of knowing what was going on in their brains at the time. Any result would have to wait (sometimes weeks and even months) until some new slight reaction was achieved.

It gave me great impetus, therefore when I saw a Canadian Broadcasting Centre Film featuring Dr Norman Doidge, author of ‘The Brain that Changes Itself’ in which one of the neuroscientists, Dr Alvara Pascual-Leone, showed how, by just thinking of an action, the same area within the brain becomes activated in the same way as when you are doing the action for real. The brain begins to form new pathways purely by thinking.

Doidge also shows how stroke survivors can be further helped by using ‘behaviourist’ specialist Edward Taub’s Constraint-Induced (CI) Movement Therapy. In this treatment, the patient is given intense therapy for many hours a day. Taub has shown that, by constraining the good limb and forcing the impaired limb to work incessantly, over a period of a few weeks, considerable improvement in the impaired limb can be achieved. With one of my own stroke clients, I am encouraging him to limit the use of his good arm throughout the day (‘by placing it in a sling’ he has suggested) and do all his activities solely with the impaired one.

With another survivor, I am working on his writing. He has discovered that since his stroke, his writing has become very small and not easy to read. I am suggesting that he uses the Making New Pathways CD I’ve given him to practice visualising writing larger and more clearly and then to use children’s writing books in real time to trace out the letters and words on ordinary tracing paper for at least an hour a day.

This scientifically shown phenomenon of the brain’s ability to change has opened up a whole new area for me. My mind is now seeking new inventive things to get these patients to try. Things that, previously, without this new knowledge, would have been thought a waste of time, now isn’t. Now I know that something is happening within the brain that is encouraging the brain to find new pathways for lost actions.

I currently have five clients working with this programme. Initially they need to be told that, if they come in, then they’re in it for the long term. Look on practicing the exercises for anything up to a year. This can be fairly daunting, so you need to offer them something to aim for. If they’re in their forties, I suggest to them that they may well have another fifty years to live. Is it worth, therefore, working hard for one year when at the end of it is the possibility that you will have forty nine years of better health? Also, how long did it take your son/daughter to learn to walk? Twelve months? So why would you expect to re-learn walking in less time? How long did it take your son/daughter to learn to speak? Eighteen months? Then why would you expect to re-learn how to form words again in less time? The secret is encouragement. Total encouragement, with the idea firmly fixed in your own mind that ….the brain wants to learn new pathways. Be inventive and try different things to encourage that learning.

It is early days yet, but I’m hopeful that we will begin to see positive results over the coming months. I’m attempting to give these survivors additional hope when their conventional rehabilitation is finished.

There is however, one important down side to this work which I would pass on to anyone wishing to explore this field. The aim is to give survivors hope. However, we may also create a ‘hopeless’ situation in their psyche. It occurred with one person I was working with. They had been unable to use their left arm for a number of years. In fact, what movement they had had, had begun to deteriorate further. However, they had accepted their condition and was coping well with all these limitations in their life. The programme gave them new hope, but, because of the continual daily effort needed before any real improvement could be seen, they began to lose heart. They even began to dislike the thought of doing the daily exercises. As they said, they preferred to continue living with their current restrictions than continue with a regime from which they could see little immediate result. They became very disheartened and we mutually agreed to drop the programme and let them instead enjoy their life within their current limitations. It is something that I am now very much aware of. The fine line between ‘hope’ and ‘hopelessness’.

Over the past month I have had enquiries from America and have one survivor working this programme with her hypnotherapist in San Francisco. A number of other hypnotherapists in the States have asked for copies of my CD and details of what I’m doing. The word is spreading.

I would like to see more hypnotherapists in the UK start to work with stroke and brain injury clients. It can even pay to reduce your rate for the satisfaction you get personally and the knowledge you gain from each survivor.

We really don’t know what the brain is capable of, so why not put it to the test and try?