Using competitive neuroplasticity to combat severe pain

“Sometimes an injury affects both our bodily tissues and the neurons in our pain system, including those in the brain and spinal cord, resulting in neuropathic pain … Neuropathic pain occurs because of the behaviour of neurons that make up our ‘brain maps’ for pain. The external parts of our body are represented in our brain, in specific processing areas. Touch a part of the body’s surface, and a specific part of the brain map, devoted to that spot, will start to fire. When the neurons in our brain maps get damaged, they fire incessant alarms, making us believe the problem is in our body … “

Michael Moskowitz, with an advanced fellowship in psychosomatic medicine, and a world leader in the use of neuroplasticity “ … wanted to understand the laws of neuroplastic change and put them into practice. He learnt that not only can one strengthen circuits between areas … but that one can weaken connections … He also learnt that in our use-it-or-lose-it brain there is ongoing competition for cortical real estate, because the activities the brain performs regularly take up more and more space in the brain by ‘stealing’ resources from other areas.”

I knew it! My brain can occasionally send a message (presumably through my subconscious) a split second before my conscious mind comes to grip with the issue. How many independent influences are there in our lives, I wonder!

Norman Doidge, in an article in the ‘Weekend Australian Magazine’ of Jan31-Feb1 titled ‘Brain, heal my pain,’ describes the way Moskowitz cleverly uses competitive plasticity to force the areas of the brain which are misfiring “to process anything but pain, to weaken … chronic pain circuits.” As one who has lived with pain for half his life, I am in wonderment.

Doidge goes on to point out that Moskowitz has replaced pain management with trying to cure persistent pain. “Years as a pain medicine specialist had fixed in his mind the key brain areas he was targeting. Each of them could process pain and do other mental functions, and he listed what each did other than process pain, so he would be prepared to do those things while he was in pain.” (Sounds like trying to tame a toddler being difficult!)

Moskowitz’s first ‘neuroplastic’ patient was one who had been declared disabled (for a decade) because of her chronic pain. He had drawn “three pictures of the brain that summarised what he had learnt. The first was a picture of the brain in acute pain, with 16 areas showing activity. The second was of the brain in chronic pain, showing those same areas firing but expanded over a large area of the brain, and the third picture was of the brain when it was not registering pain at all … … He showed her his three pictures of the brain and … asked her first to look at the pictures, then to put them down and visualise them, while thinking about transforming her brain into a no-pain version.”

Doidge then quotes the patient thus: “I looked at them all day long … I could visualise the pain centres firing, and I thought about where my pain was coming from in my back. Then I would visualise how it went into the spine and then into my brain – but with no pain centres firing … By the fourth week, the pain-free periods were up to 15 minutes to half an hour … “ Next, she started going off her medications … “the pain still hasn’t come back. It has never come back.”

Dodge continues: “Constant mental practice is necessary to strengthen this ability and change the firing of the brain that is sustained … The effects last. Moskowitz has patients who have kept their gains for five years. Many of his relatively pain-free patients still have damage in their bodies, which can, on occasion, trigger acute pain. He thinks that once they have learnt and practised the technique over hundreds of hours, their unconscious mind takes over the task of blocking pain by using competitive plasticity.”

The book is ‘The Brain’s Way of Healing’ by Norman Doidge.