Can Thoughts and Action Change Our Brains?
Can Thoughts and Action Change Our Brains?
For years, scientists believed the brain's structure couldn't be changed. The new science of neuroplasticity says that's not the case, and argue the brain is much more flexible than previously thought. Science writer Sharon Begley talks about her new book, Train Your Mind, Change Your Brain.
IRA FLATOW, host:
You're listening to TALK OF THE NATION: SCIENCE FRIDAY. I'm Ira Flatow.
You know, for years the conventional wisdom in neuroscience was that the brain you were born with was the brain you're going to carry with you for the rest of your life. Essentially it's written there as you were born. And once you killed brain cells - perhaps by a stroke, for example - that was it, you weren't coming back. And it was the structure and function of your brain that affected how you think and feel and not the other way around.
Well, all that's beginning to change. In the last few decades, scientists have shown that you actually can re-grow brain cells and you can change the structure and function of your brain by the way you think. This new science is called neuroplasticity, and it caught the attention of the Dalai Lama. Using your mind to change your brain it turns out fits in perfectly with the teachings of Buddhism, and a few years ago the Dalai Lama called some of the world's top neuroscientists to come and give him a sort of private schooling on the brain. And that meeting was captured in writing by my next guest, as she joins us now to talk about. Sharon Begley is science columnist for The Wall Street Journal. She's also the author of this new book "Train Your Mind, Change Your Brain: How a New Science Reveals Our Extraordinary Potential to Transform Ourselves," and she joins us here in our New York Bureau. Welcome back. Good to see you.
Ms. SHARON BEGLEY ("How a New Science Reveals Our Extraordinary Potential to Transform Ourselves"): Thank you, Ira.
FLATOW: Good to see you again, Sharon. What do you - you know, let's talk about this because, you know, this is just - the stuff that you have in here is amazing. But let's back up a little bit and talk about neuroplasticity. What does that mean?
Ms. BEGLEY: It just means what the two parts of the word would suggest. Neuro is of course the brain, and plasticity means a malleability, an ability to change. But what it changes in response to is what's so interesting, namely that it changes in response to the experiences you have, the life that you lead, the thoughts that you think. And that has really opened up a whole new world, because of course, you know...
Ms. BEGLEY: ...the brain changes at the - what should we call it - sort of the retail level when we have a new memory, when we learn something, but we're talking now about really wholesale changes.
FLATOW: Well, we always knew that if you practice shooting hoops with a basketball, you got better and better at it. That was because the brain was changing, right?
Ms. BEGLEY: Well, there has to be a brain change...
Ms. BEGLEY: ...because of course the brain is the organ of behavior. So if you're behaving differently, there has to be some change in the brain.
FLATOW: So what's new about neuroplasticity than just shooting hoops and practicing something over and over again?
Ms. BEGLEY: A couple of things. One is how the changes occur. In the case of shooting hoops, or indeed any athletic ability or even a musical ability, that reflects actions. It probably reflects something having to do with muscles and your sensation of touch.
But maybe the best way is to give you an example. Again, from the musical world, when you play the piano or when you learn the violin and when you become very adept at it, regions in your brain that control the fingering digits in the case of playing the violin, that control your right hand if you're playing, you know, a right-handed keyboard exercise, that motor cortex region gets larger. Again, not terribly surprising.
So a cute a little experiment at Harvard a few years ago brought in a bunch of volunteers and had them, you know, dutifully learn this keyboard exercise, and they did it before and after measurement of the region of the motor cortex that controls the fingers. And again, as you would expect, that region got bigger. But for their other group they had these volunteers just look at the music and imagine playing that same five-finger keyboard exercise. And they did this for an hour or two a day, over the course of a week - five days. So, you know, they measured their motor cortex region on Monday, and then they were imaging playing the piano for five days, and the scientists then measured the motor cortex region on Friday. And they got the same expansion of that region as happened to the people who actually played the piano. So in this case - I mean that's why people talk about how thought can change the brain, because those people were doing nothing other than imagining and thinking.
FLATOW: Mm-hmm. We've talked about many - you know, we talk about stress and emotional things that can change your mood and brain. Does it actually rewire - these things rewire the brain?
Ms. BEGLEY: Well, by rewire I mean that the connections between one region and another become stronger or different. And the most interesting connections are between the thinking part of the brain and the feeling part of the brain. Because, you know, if you want to control your emotions, whether it's in regular life and with mental health or certainly in cases of mental illness such as PTSD, Post Traumatic Stress Syndrome...
Ms. BEGLEY: ...there you do want a stronger connection between the frontal lobes which think and the limbic regions where our emotions are generated.
There was just a study, too late for the book, but people with PTSD were given this exposure therapy, which basically means whatever triggered their reliving of that traumatic experience - whether it's a sharp noise or a vision of something - they were shown or exposed to this trigger in a safe, comfortable setting, so that they did not have, you know, a true reliving of the experience, over and over and over again. And the result was the region of the brain that had been way overactive...
Ms. BEGLEY: ...in their PTSD, namely the amygdala which is where fear comes from, that quieted down. And the explanation seems to be that the thinking regions of the brain had - they send inhibitory connections to the amygdala, so inhibiting - again, quieting it down - that became stronger. As I say, it was too late to include in the book, which to me is yet another indication. I mean this stuff just keeps coming out.
FLATOW: Yeah. You mention in the book cases of depression where people were through cognitive therapy were actually able to talk themselves - is it for a better reason - think themselves out of depression.
Ms. BEGLEY: They exactly were. And this study compared cognitive behavior therapy to, you know, your basic...
FLATOW: Describe what that is.
Ms. BEGLEY: Yes.
FLATOW: What happens here?
Ms. BEGLEY: It is thinking about your thoughts in a different way. You know, to say it like that probably doesn't do it justice because it is a somewhat long process. People tend to go in for an hour a day, once or twice a week, for maybe two months. So we're not talking about, you know, Woody Allen-kind of psychotherapy.
Ms. BEGLEY: You're not signing up for 40 years. And in the case of depression, cognitive behavior therapy teaches you to basically not catastrophize. So people who suffer from depression tend to take what other people would be a minor setback - they had a lousy date, their roof leaks, they - something bad happens at work - and that gets parlayed or that avalanches into no one will ever love me, nothing will ever go right.
Anyway, with cognitive behavior therapy, they learn to view these thoughts as either aberrations of the brain or as just factually incorrect. You know, when I - again, when I describe it like that, it's not that simple.
Ms. BEGLEY: It's not like you can just - your listeners can say, OK, now I'm going to think that way. It does take training and effort and all that good stuff. But anyway, the effect was people were able to dial down activity in the frontal part of the brain, right behind the forehead, which is where ruminations come from. Again, it's the thinking part of the brain. And if you over think, if you're forever obsessing on no one will ever love me or whatever...
Ms. BEGLEY: ...you want to dial down that activity.
FLATOW: And it actually brought them out of their depression as well as the drugs did it.
Ms. BEGLEY: As well as the drugs. And not only that, it prevented relapse better than the drugs, because unfortunately with the serotonin reuptake inhibitors - the Zoloft, and Paxils, and Prozacs of the world - you almost always have to stay on them for, well, forever.
Ms. BEGLEY: And if you stop taking them, there's a very high risk of relapse. But if you learn to think differently, that just seems to have a - I hesitate to say permanent - but let's say an enduring effect on the brain because you really have retrained your brain, and the relapse rate is cut by two-thirds.
FLATOW: How much of therapy then can we substitute, or thinking about health, for maybe taking medications, drugs and things like that?
Ms. BEGLEY: Well, you're trying to get me trouble, but...
(Soundbite of laughter)
Ms. BEGLEY: You know...
FLATOW: I think you're good at doing that yourself.
(Soundbite of laughter)
Ms. BEGLEY: Thank you. You know, if you ask can you think your way out of schizophrenia or think your way out of autism, you know, if I were to bet you a nickel, I'm going to say no. There are some brain illness that are just too extreme. Certainly I would put Alzheimer's disease in there, too. You're not going to think your way out of something this extreme, this horrific. But, you know, for others, perhaps it will take medication to get you to a point where you can benefit from cognitive behavior therapy. But in other cases people can go into cognitive behavior therapy with no medication. Again, as I say, ask your doctor.
FLATOW: Yeah, ask your doctor. There was a really other - there's so much fascinating in this book "Train Your Mind, Change Your Brain" and enlightening. And for example, stroke, rehabilitation from stroke, where you can think yourself back to using a limb that was put out of commission by a stroke.
Ms. BEGLEY: This scientist's research is so fascinating because of his personal story and how - I mean the very idea that people who are, you know, decades post-stroke can indeed regain some function. I mean that's anathema to the neuro community and even to the rehab community. And when this scientist, who's name is Edward Taub - he's at the University of Alabama - began to find evidence of this, you know, he could not get NIH grants, nobody would listen to him, nobody would collaborate with him. You know, people I think have the impression that scientists are always, you know, waging a revolution. Science is actually quite conservative. If you are attacking the dogma, you don't make a lot of friends.
Anyway, he found that if let's say the region of the brain that was knocked out by the stroke is in the right motor cortex and as a result you can't move your left arm, you can retrain the brain so that a different region takes over that function.
It's not only thinking. There has to be some movement. Basically you force that immobile hand to move.
FLATOW: Right. Right. And in fact he did it by strapping down the other hand, the other arm, right? So you could not use it if you wanted to.
Ms. BEGLEY: He ties it behind your back. And you just have to force - sometimes with a therapist. Sometimes with someone you live with. You just force, force, force that arm - it also works with lower limbs with legs - to do what it's supposed to do.
And, you know, you asked earlier about how widespread the changes in the brain are. In this case instead of having the right motor cortex control the left arm, the left motor cortex steps up to the plate. It's like, you know, the guy who was supposed to be hitting up there is suddenly on the disabled list. And the pinch hitter steps up.
FLATOW: Wow. And that's because we can grow new neurons in the brain where we never thought you could before. We always thought you were left with what you started out with in life. Maybe there's some plasticity when you're a teenager, right?
But now you're talking about in your book that in all stages of our lives we're able to grow and bud flower, as you say, new neurons.
Ms. BEGLEY: Yet another dogma that, you know, is now in the dust bin in history. It was thought that it would just basically not be a good idea if the brain made new neurons once we reached, you know, the ripe old age of two because analogous, let's say, to a computer or any other fancy electronic device, what good will it do to drop new wires in there?
Ms. BEGLEY: I mean this device was, you know, wired up perfectly. It's a brain, for Pete's sake. How could it benefit from having new neurons suddenly show up?
So this was yet another case where science had deemed something impossible without really ruling it out empirically.
Anyway, so it was discovered indeed, almost 10 years ago, that well into adulthood - and we're talking about in your 50s and 60s and 70s - neurons continue to be born. It's a process called neurogenesis.
And they seem to insinuate themselves, to weave themselves into some existing circuitry, probably that having to deal with memory. And that might be one mechanism by which our memories - or some people, some of our memories - remain at least sort of robust as we get older.
FLATOW: Hm-hmm. Hm-hmm. An interesting - another - there's so much to talk about, as I say. Another interesting fact you brought out in your book was what were experiments that showed to grow these neurons scientists had animals in the laboratory exercise.
I mean why would you - they - neurons were popping up as they were on their little treadmills in the laboratory.
Ms. BEGLEY: Who would have thought?
FLATOW: And only if they wanted to. If they were forced to they didn't grow these ones. But if they really - hey, I like to run that treadmill - new neurons grew.
Ms. BEGLEY: Yes. Everybody should use that. If, you know, your significant other is telling you to exercise, you say no, I don't want to. It will not do me any good.
You're familiar with all the good stuff that supposedly comes from a so-called enriched environment...
Ms. BEGLEY: ...and how, you know, rats are - your favorite lab animal - grow new neurons and new synapses and they're smarter and they can run around the maze.
This thing called an enriched environment is very complicated. It has cool toys. It has other cute little playmates. And it has running wheels. So when scientists drew these conclusions about the benefits of an enriched environment they actually didn't know which aspect of it was doing these good things.
So finally Fred Gage at the Salk Institute teased apart the different elements of this enriched environment and found that indeed it was the running wheel...
Ms. BEGLEY: ...that was causing new neurons to be born.
FLATOW: Talking about the brain and neuroplasticity this hour on TALK OF THE NATION: SCIENCE FRIDAY from NPR News. Talking with Sharon Begley, author of, "Train Your Mind, Change Your Brain: How a New Science Reveals Our Extraordinary Potential to Transform Ourselves."
What did you find - you've spent years looking at this. What did you find the most fantastic part of all of this?
Ms. BEGLEY: I have to say it was that the whole cell changes in the brain just completely threw out the window the pictures that we've all seen in which the brain is depicted as sort of a, you know, an urban neighborhood with neighborhoods designated as, you know, this is where you see, this is where you touch, this is where you hear, this is where you analyze metaphors.
I mean it's gotten down to just a crazy level of specificity.
Ms. BEGLEY: And my favorite is one that frankly is not all that applicable to, you know, people who have emotional illness or mental illness. But it's that - the visual cortex which is about a third of the whole brain.
And you think what could be more hard wired than that. I mean what is more basic than this is the part of the brain...
Ms. BEGLEY: ...that handles information from the eye. If you are born blind or if you become blind very young in your life the visual cortex basically gets the message, gee, there's not going to be any signals coming from the eye. I better get a new gig.
And it switches over to processing sensations from the fingers or to hearing. And again, you know, it doesn't have the applicability of the stroke...
Ms. BEGLEY: ...research that we talked about and depression and everything else. But to me that was just such a way to pull - if the visual cortex can do something different then how can we sit here and say that these much more minute regions and circuits can't also, you know, be altered.
FLATOW: Hm-hmm. And you just - they discovered things that you talk about with people who are Braille readers and how the fingers get rewired.
Ms. BEGLEY: Exactly. Which unfortunately so the people who are blind from a very young age or from birth, their visual cortex then processes what their fingers feel when they read Braille which meant that in the case of one unfortunately lady she suffered a stroke in her visual cortex. And you think gee, blind person, stroke and visual cortex, what's the problem?
Ms. BEGLEY: But of course her visual cortex was enable her to feel the Braille dots.
FLATOW: Now you talk - you weaved throughout your book conversations in front of the Dalai Lama, all these world-famous scientists coming in front of the Dalai Lama.
Did they have to be talked into talking to the Dalai Lama?
Ms. BEGLEY: Not really. This is an invitation that apparently you don't refuse.
(Soundbite of laughter)
Ms. BEGLEY: This was a meeting held in Dharamsala - which is the home of the Dalai Lama in exile. And he as you said has long been interested in science and particularly neuroscience because it resonates with Buddhist teachings.
And he invited half a dozen scientists to go tell him about their research. And he in turn invited a number of Buddhist scholars, Monks, and academics who tried to contribute something from Buddhism.
In other words because Buddhism has as one of its tenants the power of mental training - a huge focus on meditation - just what has this, you know, personal experience shown about the power of mental training that might be useful to the scientists.
FLATOW: Hm-hmm. We're going to take a short break, come back, and take your calls. I know you all want to talk to Sharon Begley, author of, "Train Your Mind, Change Your Brain: How a New Science Reveals Our Extraordinary Potential to Transform Ourselves."
We'll talk a bit about what the scientists may have learned from the Buddhists and the Monks and their tests. So stay with us. We'll be right back after this short break.
I'm Ira Flatow. This is TALK OF THE NATION: SCIENCE FRIDAY from NPR News.
(Soundbite of music)
FLATOW: This is TALK OF THE NATION: SCIENCE FRIDAY. I'm Ira Flatow. We're talking this hour about brain plasticity with my guest, Sharon Begley, who is science columnist for The Wall Street Journal and author of the new book, "Train Your Mind, Change Your Brain."
1-800-989-8255. Let's go to the phones. Let's see who we got. Let's go to Richard in California.
RICHARD (Caller): Hi. This is Rich. I really love your columns in the Journal. I always look forward to them. Excellent work. I use her as an example of career in science when I talk to high school students.
My question relates to whether we're talking about plasticity in the brain as it is basically changing existing functionality or whether she has seen anything in the research she's been looking at that might affect children and who have some learning disabilities, whether there's a possibility of - through plasticity and maybe other types of science like stem cells or something - whether there's an opportunity to do any augmentation?
Or are we too - are we way far out when we go that direction? I'll take my answer off the air.
Ms. BEGLEY: The most direct connection so far has been to dyslexia. And it turns out that in at least most cases of dyslexia the problem is auditory.
It used to be thought that children who had dyslexia couldn't tell the difference between letters that were mere images of each other and therefore it was a visual problem. But it turns out instead that in dyslexia you can't hear the difference between what are called fast phonemes, explosive sounds like Ps and Ds.
And, you know, just as with stroke therapy where you find out what's wrong with the brain and figure out the input that will change it, for dyslexia a number of scientists centered at the University of California in San Francisco developed an intervention, shall we call it, which feeds synthesized speech into the children's brains - I mean they hear it in ear phones - and that slowly retrains the auditory cortex so that it can distinguish these fast phonemes.
And then, you know, when you're learning to read and someone tells you this letter sounds like this, well, it's nice to be able to hear what this sounds like.
But your question is fascinating because clearly the - one of the greatest potentials of this is in learning and education.
The short answer is I'm not aware of any research that has gone that way so far. But I've heard from so many educators who have suggested that there must be something here.
And if it follows the track that other neuroplasticity research has, the first chore - the first goal - will be to identify what is not quite right in the brain of children who have trouble learning and remembering and then figuring out what the input is.
It won't be easy. But it's been shown in, again, so many other cases that it's possible.
FLATOW: Hm-hmm. You talked about - and we mentioned before about treating stroke victims to reuse their limbs. And I'm going to read from your own Wall Street Journal article in the January 8th by Thomas Burton who says, why some patients get no help after brain injury, many insurance firms doubt therapy's uses and talks about how even though there are these new ideas and new therapies, the companies - the insurance companies - are not going to pay for them.
Ms. BEGLEY: And, I mean, what could be worse? And these are therapies that have gone through National Institutes of Health sponsor trials with flying colors. It does go against the dogma. And all you can say is that you hope slowly that reimbursement will be possible.
FLATOW: Hm. 1-800-989-8255. Let's - let's go to John(ph) in Davenport. Hi, John.
JOHN (Caller): Hello.
FLATOW: Hi there.
JOHN: I have a bit of laryngitis. But I'll do...
FLATOW: Join the crowd.
JOHN: ...thank you. I'll do this quickly. Your guest said that she didn't think that perhaps severe mental illnesses like schizophrenia could be cured or corrected by this method.
I am a paranoid schizophrenic. I have suffered from the disease for 35 years. Thirteen years ago my therapist, Dr. Paul Elias(ph), and I began working out a method of cognitive therapy whereby I would go through and list all of the things I believed in and then by the method we developed change my world view.
And although I have been a patient in 2000, a research subject at the Mental Health Clinical Research Center at the University of Iowa under Nancy Andreasen, Dr. Andreasen - which proved by PET and MRI scans that my brain is typically a schizophrenic brain - I am now and have been - although not able to work full time - able to think cogently.
And I have - I am presently a commissioner for the State of Iowa. I'm the Mental Health/Mental Retardation Developmental Disability and Brain Injury Commission. And I was just recently given a position on the NAMI Iowa National Executive Committee. I think there is hope that although you can't change the brain structure of a schizophrenic entirely, you can change it so that you can - the schizophrenic can think realistically and clearly. And I think that most of this is done by using the medications that the person has to give them a grounding so they can start thinking coherently.
JOHN: That's all I wanted to say.
FLATOW: Thank you, John.
Ms. BEGLEY: All I can say is wow. And I'm delighted to stand to corrected. You know, medications for schizophrenia have not only so many side effects but are not effective. Too many patients that - if this therapy can indeed be widely practiced, what could be better?
FLATOW: At their meeting yesterday, talking about the future of - on a panel, talking about the future of research, and I jokingly said, you know, people were saying, what's the future? And I brought up the old movie line, plastics, you know. And somebody came up to me later and said, neuroplastics. And it seems that this is really moving very quickly.
Ms. BEGLEY: It really is. You know, I started the book for more than two years ago. And at that point there were, you know, a few little studies here and there. But you know, as always when you finish your book, as soon as you turn in the manuscript, you see more cool stuff. And I mean clearly this really has turned around neuroscience.
FLATOW: You mentioned something about the relationship between Buddhism and neuroplasticity and the fact that you say attention training is so important in Buddhism and is also recognized to be very important by scientists. Talk about that a bit.
Ms. BEGLEY: Because when we talk about the inputs that have shifted around brain regions so that, again, you have a larger region of motor cortex that controls your fingers when you play a musical instrument, and there are just numerous cases like that, none of those changes take effect unless you have been paying attention to the input. And you can be a human being or - and a - or a monkey; if you are not paying attention to that input, you can have the exact same, you know, taps on your fingers or sounds coming into your ears, and it will not lead to the sculptural effects on the motor cortex or the auditory cortex. So attention is not some, you know, sort of "Twilight Zone" thing. It has a physical reality. And clearly it has to be present for these brain changes to occur.
FLATOW: And these medidators are very good at paying attention.
Ms. BEGLEY: There are number of forms of meditation, and attention meditation is one of them. And to get back to an earlier caller, some groups are trying to get attention meditation into the school system with, you know, you can predict the sort of expected resistance from parents about, oh, they're trying to, you know, brainwash my children. But you know, if really this meditation can help some kids who have trouble focusing, maybe we should try it.
FLATOW: You write about the meetings between these scientists presenting to the Dalai Lama, and he listening to them. Was there any reverse - did the scientists learn anything that they can use in their own work, from how the - the Buddhist teachings?
Ms. BEGLEY: The scientists most benefited and are benefiting from the monks and other Buddhists who are lending their brains to them. And by that I mean at a lab at the University of Wisconsin in Madison there is just a sort of constant stream of visiting Buddhist scholars and practitioners who will undergo meditation while sitting in a FMRI tube or with electrodes over their heads, and the scientists will say turn on compassion meditation; turn off compassion meditation; turn this on; turn that on.
And their brain activity is being measured. And the idea there is to see not really what happens when the brain is meditating, because I don't know about you but I'm getting tired of seeing all these, you know, pretty brain scans, because of course the brain is doing something when, you know, you're thinking or feeling or believing or imagining. What's more interesting is whether those activity changes last past the actual, you know, period of meditation.
And what is being found is that those changes do last, that, I mean, I call it a change in a brain trait as opposed to a brain state. The state is what happens during meditation, but trait is more enduring. So this too is suggesting that with the practice of meditation - again, just one form of mental training - you can indeed shift some brain activity.
FLATOW: What is the Dalai Lama's view on science. Buddhism and science aren't really at odds, the way let's say religion and science often are in this country, is it?
Ms. BEGLEY: Because Buddhism is not your typical religion. I mean, it's more of a philosophy. It does not have a creator god. It's not about absolutes. It's tentative in really quite the same way that science is tentative. You never believe that you have reached absolute knowledge. And the Dalai Lama says repeatedly that if science disproves something that Buddhism has long held, then out with it. Buddhism has to let it go. So he is quite open, which means that he is, you know, delighted to lend his monks to the scientists even, you know, if science disproves something about the power of mental training or whatever. He wants to know about it.
FLATOW: How - has this changed you, writing this book? I mean, you've been writing science for years. I've known you for decades. You write great science. Has it changed the way you view science at all?
Ms. BEGLEY: It has not made me take up meditation, but that just reflects the fact that I haven't decided it's safe to meditate on the New York City subways. It has made me even more convinced that hardwiring is just empirically incorrect. I've - you know, whether at the Wall Street Journal or elsewhere, I admit that I've never really been convinced about, you know, the power of genetics or the power of, again, hardwiring in the brain.
And this has shown me yet other studies, more research, a whole, you know, field of science that disproves this idea that, you know, you don't have any power over who you are or what you become, which I find, yes, personally appealing. I mean, it's more - I mean, Lord knows it's more optimistic than the idea that the brain you enter the ripe old age of three with is the brain you're going to be stuck with forever.
FLATOW: Let's go to Kaye in Phoenix. Hi, Kaye. Welcome to SCIENCE FRIDAY.
KAYE (Caller): Thank you.
FLATOW: Go ahead.
KAYE: I have a clinic in Phoenix, a physical therapy clinic that specializes in stroke rehabilitation. We've based our whole philosophy of treatment on this neuroplasticity philosophy. I really appreciate your comment. What I was wondering is, we're finding success with people. And it doesn't matter how many years past stroke they are; we're still getting very nice success. It does take a lot of, just a lot of repetitions and a lot of time. Do you have any comments or research on just how much repetition and how much time it takes?
Ms. BEGLEY: Edward Taub, who developed this, he calls it constraint induced movement therapy, but there are other variations, he would have patients come in for an entire working day - seven or eight hours every day, five days a week for - don't hold me to this, I believe it was at least two months. So it's a full time job.
Ms. BEGLEY: It's not like, you know, cognitive behavior therapy where you show up an hour a week. It's hugely intensive. It's hugely labor intensive for the trained medical staff at a clinic or at a hospital. So exactly for the reason you're saying, it has not spread because we do not have in this country the, you know, the reimbursement system and indeed the medical staff that can devote themselves to this kind of intensive therapy at enough places.
That said, Taub is trying to develop an at-home version of this where you can through some set-up with the computer and just your own efforts possibly do this remotely, which would probably - well, almost certainly - bring down the cost and ideally make it available to more people, including those who can't reach clinics like yours.
FLATOW: You're listening to TALK OF THE NATION: SCIENCE FRIDAY from NPR News.
Is there any way, Kaye, that you can get reimbursement on these therapies?
KAYE: Well, actually, we're doing pretty good on the reimbursement part. We have to do a lot of work, and we have to get preauthorization. And we do do constraint induced therapy, very little of it, because most of the patients that come to us are lower level functioning than the constraint induced, which - which is, you know, so we have to address it a little bit differently. And so we're kind of grappling with that and doing some sort of clinical research on our own. But how much time it takes with the lower level, lower functioning stroke survivors is difficult.
FLATOW: Well, thanks for calling and sharing that with us. Good luck to you.
KAYE: Thank you.
FLATOW: What about other therapies, you know. I'm thinking of addiction: drug addiction, alcohol addiction, smoking addiction. Is there - might it be possible to talk yourself out of that too?
Ms. BEGLEY: Well, apparently a number of substance abuse counselors think so. Because I heard from just, gosh, I must have heard from dozen of them after the book came out, saying this really fits with something that we have long thought. So the short answer is I did not come across any research in that. But it makes sense, because there has been so much research that has documented where in the brain, you know, whether it's a problem with the dopamine system, where in the brain addiction seems to take hold. So again, it's a matter of you identify what's wrong in the brain and then figure out the input that can, you know, turn it back.
FLATOW: Right. Well, it's like the stroke - until someone decided, hey, let's try it, everybody laughed, right? Somebody could decide to say let's try cognitive behavior therapy on addiction.
Ms. BEGLEY: Exactly.
FLATOW: But you - and now, we're understanding the pathways of addiction in the brain. You know, you just have to figure out some therapy.
Ms. BEGLEY: Exactly. And you know, the new generation of neuroscientists are not as wedded to the old dogma. I mean, that's, you know, what do they say, that science revolutions happen when old scientist die. So I am indeed getting the feeling that more and more people are willing to try this.
FLATOW: Well, I want to thank you for taking time to be with us today. And I'm sure you're going to be following up on this, right?
Ms. BEGLEY: There is a lot to write about.
FLATOW: This is a lot, and this is a terrific book. I mean, I read this whole book in one reading. I was so interested in this. I took the two hours and read the whole book. And it's easy - it's written very well. If you want to know everything that you wanted to know about training your mind to change your brain, it sounds like it's a self-help book, but it's not. The title sounds like, you know, hey, how to like - losing weight - it's not.
It's a book about the research, the really well-documented and well-collected research how plastic and - somebody said, what plastic? Do you have plastic in your brain? I said, no, no. That's just a term. That means that it's malleable. And that's why they call plastic plastic, because you can bend it and things like that. Another topic. "Train Your Mind, Change Your Brain" - with us, Sharon Begley - "How a New Science Reveals Our Extraordinary Potential to Transform our Lives." Good luck to you, Sharon.
Ms. BEGLEY: Thank you, Ira.
FLATOW: And thank you for taking time to be with us today.
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