In our last post we alluded to, among many things, the importance of INHIBITION- the ability of the higher centres in our brain to wrestle control away from our lower (and more demanding) centres of our brain. A brain which is under more subcortical control is one that is held hostage by more primitive drives such as sex, food, threat and instant rewards. In this state, it is very difficult to develop the AWA skills of change management, particularly when well ingrained negative plasticity has developed in the CNS.
As a review, neuroplasticity is the ability to build (and maintain) a pathway in the CNS. We can have;
Negative plasticity- which will produce negative outcomes such as PTSD or chronic pain.
or
Positive plasticity- which will produce positive outcomes such as mastering the guitar or healthy cortical modulation of sympathetic activity (via PMRF activation).
As doctors, we are exposed to the negative, and sometimes positive, aspects of neuroplasticity in our patients every single day. They are reflected in our patients' pain syndromes, muscle imbalances, altered gait mechanics, postural distortions, autonomic imbalances and so on. They are also reflected in our patients' return to normal function and resultant maintenance of that function via our interventions and recommended self-care protocols. So does the same principle apply to our topic of Stimulus-Bound vs Goal-Directed behaviour and change management? Is spending your money impulsively (and not paying down debt) to "keep up with the Jones'" a form of negative plasticity and therefore a reflection of the maturation of your CNS? Well the short answer is yes. For some reading this, you may have felt a little twinge in the gut just now. But thats the first step to change. The truth, however, is that we have examples of both negative and positive plasticity in our lives. My advice.....don't change a thing with the positive plasticity thats working for you and change the negative plasticity that's not working for you. Sounds simple but most people suffer from some form of anosognosia, which is just a fancy way of saying that sometimes you don't know what you don't know. And in the arena of negative plasticity, ignorance is NOT bliss!
Consider the physiological blind spot that we all have. That small area on the optic disc of the retina that contains no photoreceptor cells. Well guess what? You don't know its there because your brain fills in the gap and literally makes things up to fill in the visual representation of that spot. This can be measured and, to go a step further, used as an objective measure of brain function. Our brains are incredibly adept predicting machines. Starved of the necessary information that it needs (as in the case of a subluxation), it will make things up to account for the void. Perception may not reflect reality as a result.
So now the question is, do we have cognitive or emotional blind spots with regards to our behaviour? What things do we "make up" in an effort to provide a rationalization for our own "blind spots"? Better yet, can we measure it, change it and then measure it again? Yes and yes. Neuroscience suggests that psychology is a reflection of physiology, specifically neurophysiology. This may come across as a deterministic (which is distinctly different from mechanistic) concept but it is not, because there is no room for change in determinism. On the flip side, emergent vitalism (or neo-vitalism) allows for the limitless confounding variables that shape and mould who we are now AND who we can become. We truly are greater than the sum of our parts since, as epigenetics has proven, our environment plays a role in that evolution as well....but I philosophically digress.
I promised in the last post to address this idea of assessing and changing our own inhibitory skills so that we can shift our behaviours from more stimulus-bound to the goal-directed kind. Let's use the backdrop of a nice little scientific review written by Douglas Munoz and Stefan Everling in Nature (2004)entitled "Look away: The anti-saccade task and the voluntary control of eye movement".
As an aside, I think many chiropractors are missing an opportunity to improve their assessment of the nervous system by not becoming trained in the examination of the eyes. The eyes and the spine are embryological homologues and therefore stayed wired together for life. Therefore, from a neurological perspective, what happens in the eyes....happens in the spine. And the eyes are not buried underneath 5 layers of muscle, adipose tissue and skin so it makes for an easy qualitative, and with the right technology, quantitative evaluation. So for me, those two little globes are like vertebrae to assess.
First line of the article. "The anti-saccade task has emerged as an important task for investigating the flexible control we have over behaviour". In this task, participants must suppress the reflexive urge to look at a visual target that appears suddenly in the peripheral visual field and must instead look away from the target in the opposite direction. Ladies, think of this test as a measurement of your husband's ability to not gawk at a well-endowed woman walking towards you as the two of you stroll past holding hands. Get the picture. A simple way to perform it is to hold out both your thumbs approx 40-50 cm apart and randomly wiggle one thumb and then instruct the person you are testing to dart their eyes in the opposite direction of the wiggling thumb. Can they inhibit the reflexive urge to look towards the target stimuli (wiggling thumb) known as an automatic saccade? Disorders or dysfunction in the executive centres of the brain (namely the frontal lobe) find it difficult to suppress this urge revealing a deficit in top-down inhibition. There are several other tests you could do to test frontal lobe maturation but beyond the scope of this blog.
Frontal lobe and eye exercises such as pursuits, saccades and various other brain "gym" activities therefore become great ways at building plasticity for the inhibitory skills necessary to develop goal directed behaviours. There is a caveat, however. You must be specific to the hemisphericity, or under-connected side of the brain otherwise exercises or activities that target the wrong hemisphere or are too bilaterally general will not create that positive plasticity in flexible behaviour control and can in fact, worsen an already existing negative plastic state. This, of course, must be skillfully assessed. Targeted plasticity after a skilled assessment is the key to rubbing the neuroplastic genie. Be open to being checked by someone trained in a comprehensive functional neurological assessment.
You never know, you might just be cured of your anosognosia.
